In comments to the Department of Health and Human Services, the National Health Law Program urges HHS to reject Massachusetts’ proposed request to waiver to obtain federal finanical participation for services provided in Institutions for Mental Diseases (IMD). HHS should reject Massachusett’s application because Massachusetts did not provide adequate state-level notice and opportunity to comment prior to submitting this amendment. Further, HHS does not have authority to grant the request to waive the IMD exclusion because Massachusetts has not proposed a genuine experiment, and the Secretary may only waive requirements of the federal Medicaid Act to conduct an experiment or test a novel approach to improve medical assistance for low-income individuals. Furthermore, Section 1115 only permits waiver of those requirements found in 42 U.S.C. § 1396a, and the IMD exclusion lies outside of 42 U.S.C. § 1396a. Last, the proposal risks diverting funds away from appropriate community-based services, undermining decades of progress towards increased community-integration.