Section 1115 Medicaid waivers allow states to explore new options for providing health coverage to persons who would otherwise not be eligible and allow states to examine innovative ways to deliver care by waiving certain requirements of the Medicaid Act.
While waivers can be important tools that can help states respond to the needs of low-income individuals, they also present concerns for health advocates working to protect the rights of Medicaid enrollees and promote transparency in state waiver processes.
Sec. 1115 of the Social Security Act allows the Secretary of Health and Human Services to waive some requirements of the Medicaid Act so that states can test novel approaches to improving medical assistance for low-income people.
Under the current administration, several states are seeking waivers to impose harmful cuts and restrictions. The first set of harmful waivers have been approved for Kentucky and Arkansas, with a number of states seeking to enact similar changes to Medicaid. Learn more about Medicaid waivers and how the National Health Law Program is combating the Trump administration’s illegal use of waivers to weaken Medicaid.
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- July 23, 2013
For full publication text, download document.
- July 23, 2013
Raleigh, NC - A federal District Court today ordered the State of North Carolina to halt reductions to home and community based services and restore lost services until the state Medicaid agency and its managed care contractor, Piedmont Behavioral Healthcare (PBH), comply with legal requirements for providing Medicaid beneficiaries with adequate notices and opportunities for impartial hearings when their services are denied, reduced or terminated. The Court noted that without an injunction, the plaintiffs-children and adults with disabilities-would experience deteriorating health, financial strains, and the threat of having to go into institutions to get care. "We are gratified by the court's thorough, careful analysis and hopeful that the state and PBH will quickly accept this decision and correct their illegal practices," said Doug Sea, an attorney at Legal Services of Southern Piedmont. "Scores of our most vulnerable citizens desperately need the services that have been taken away from them, without due process, to be promptly restored." Judge Louise Flanagan's decision found that the plaintiffs are likely to succeed on the merits of their legal claims that the Medicaid agency and PBH are not complying with the most basic federal constitutional and statutory requirements for participating…
- July 23, 2013
District Court opinion granting summary judgment and permanently enjoining enforcement of legislation that would exclude Planned Parenthood of Central NC from receiving otherwise available funding for contraceptive and teen pregnancy prevention programs.