Waiver 1115 Information

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.

View 1115 Waiver Resources By State

results in Waivers and Demonstrations and Oklahoma.
  • NHeLP Comments on Oklahoma Section 1115 Institutions for Mental Disease (IMD) Waiver for Serious Mental Illness/Substance Use Disorder

    NHeLP urges the Secretary not to approve the requested waiver because 1) Oklahoma asks the Secretary to waive provisions of the Medicaid Act the Secretary does not have the authority to waive; 2) Oklahoma has not proposed a genuine experiment or novel approach; 3) Oklahoma’s proposal risks diverting funds away from community-based services, undermining decades of progress toward increased community-integration; and 4) the Secretary does not have authority to approve a Section 1115 waiver that would enable Qualified Residential Treatment Programs (QRTPs) to receive federal financial participation (FFP) for psychiatric treatment for individuals under 21 with SMI.

  • Comments: Oklahoma Section 1115 Application.

    In comments to the Department of Health and Human Services, the National Health Law Program asks HHS to reject Oklahoma's proposed project, which would impose a number of unlawful conditions on coverage and access to care. Oklahoma also requested permission to shift to per capita cap funding for the Medicaid expansion population.

  • Letter Calls on Seema Verma to Reject Oklahoma’s Section 1115 Request Following Ballot Initiative

    In a letter to the Center on Medicare & Medicaid Services, the National Health Law Program requested that Administrator Verma reject Oklahoma's SoonerCare 2.0 application. The proposed 1115 waiver project would violate recent changes to Oklahoma law following the June 30, 2020 ballot initiative that amended the Oklahoma Constitution to require the state to expand Medicaid. The ballot initiative included several protections for the expansion population, which would conflict with the SoonerCare2.0 proposal.

  • SoonerCare 1115 Waiver Evaluation: Final Report Part 1

    External Source

    SoonerCare 1115  Waiver Evaluation:  Final Report  January 2009  James Verdier, JD  Margaret Colby, MPP  Debra Lipson, MHSA  Samuel Simon, PhD  Christal Stone, MPH  Thomas Bell, MBA  Vivian Byrd, MPP  Mindy Lipson  Victoria Pérez Submitted to:  Oklahoma Health Care Authority  4545 N. Lincoln Blvd., Suite 124  Oklahoma City, OK 73105  Project Officer:  Beth Van Horn  Submitted by:  Mathematica Policy Research, Inc.  600 Maryland Ave. S.W., Suite 550  Washington, DC 20024-2512  Telephone: (202) 484-9220  Facsimile: (202) 863-1763  Project Director:  Jim Verdier CONTENTS    Chapter Page     FINAL EVALUATION SUMMARY ........................................................................ xiii  I INTRODUCTION ..........................................................................................................1 A. PURPOSE ................................................................................................................1 B. METHODS ..............................................................................................................2   II SOONERCARE PROGRAM STRUCTURE AND HISTORY .....................................5 A. INTRODUCTION ...................................................................................................5 B. THE ORIGIN AND EARLY YEARS OF SOONERCARE: 1992 TO 1996 .........6 1. Search for a Solution to Burgeoning Medicaid Costs, 1992 and 1993 ............6 2. No Expansion of Medicaid Eligibility in Original SoonerCare Waivers.........8 3. The Oklahoma Health Care Authority .............................................................8 4. The SoonerCare Managed Care Program ........................................................9 5. 1997 Evaluation of Initial Implementation of SoonerCare…

  • SoonerCare 1115 Waiver Evaluation: Final Report Part 2

    External Source

    This report describes the SoonerCare 1115 Waiver program including participation rates, quality measures, and financial outcomes.

  • SoonerCare 1115 Waiver Evaluation: Presentation to Oklahoma Health Care Authori

    External Source

    For full publication text, download document.

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