Waivers

• 1115(a)
  • Arkansas
    • On December 20, CMS approved an amendment to Arkansas’s 1115 demonstration titled, “Arkansas Healthy Opportunity for Me (ARHOME).” The state receives authority to provide non-medical transportation to and from HRSN services for eligible beneficiaries. The demonstration is effective through December 31, 2026.
  • Arizona
    • On December 27, CMS approved Arizona’s request to amend its 1115 demonstration. The state receives authority to provide limited coverage for eligible incarcerated individuals for up to 90 days prior to the individual’s anticipated date of release. This approval also provides expenditure authority for non-medical transportation to and from HCBS and HRSN services for eligible beneficiaries under the Arizona Long Term Care System. The demonstration is effective through September 30, 2027.
  • Colorado
    • On December 23, Colorado submitted a request to extend its 1115 demonstration titled, “Expanding the Substance Use Disorder (SUD) Continuum of Care.” The state requests that the demonstration be renamed, “Comprehensive Care for Colorado” effective January 1, 2026. Colorado seeks renewed authority to provide SUD treatment services to short-term residents in residential and inpatient treatment settings that qualify as IMDs. With this extension, the state is seeking new authority to incorporate presumptive eligibility for Long-Term Services and Supports. The state requests to incorporate all pending amendment requests into this demonstration, which includes continuous eligibility for children ages 0 to 3 and 12 months of continuous coverage for individuals leaving incarceration; reentry services for adults and youth leaving correctional facilities; reimbursement for acute inpatient and residential stays in IMDs for individuals with SMI or SED; and HRSN services for housing and nutrition support. The federal public comment period is open until February 5, 2025.
  • Idaho
    • On December 20, Idaho submitted a request to amend its 1115 demonstration titled, “IMD Behavioral Health Transformation Demonstration.” The state seeks to remove expenditure authority that allows the use of legally responsible individuals to provide personal care services. Idaho cites unanticipated and unsustainable program growth as well as a number of incidents of suspected and confirmed fraud and abuse that are unable to be resolved by the state agency given current constraints. The state requests an effective date of January 31, 2025. The federal public comment period is open until January 31, 2025.
  • Indiana
    • On December 20, Indiana submitted a request for a five-year extension of its 1115 demonstration titled, “Healthy Indiana Plan (HIP).” The state seeks authority to continue its Substance Use Disorder and Serious Mental Illness programs as currently approved. Indiana is seeking new authority to provide coverage for former foster care youth in accordance with the new eligibility group created by the SUPPORT Act. The federal public comment period is open until February 1, 2025.
  • Michigan
    • On December 27, CMS approved Michigan’s request for a new Reentry Services 1115 demonstration. The state receives authority to provide limited coverage for eligible incarcerated individuals for up to 90 days prior to the individual’s anticipated date of release. This includes youth who are or would be eligible for CHIP if not for their incarceration status. Michigan has been selected to provide services in state prisons, county jails, tribal correctional facilities, and juvenile facilities. The demonstration is effective through December 31, 2029.
  • Minnesota
    • On January 2, CMS approved a five-year extension for Minnesota’s 1115 demonstration titled, “Minnesota Reform: Pathways to Independence (Reform).” The state receives renewed authority to provide home- and community-based services to beneficiaries aged 65 and older in need of nursing facility-level care and who are not otherwise eligible for 1915(c) Medicaid HCBS programs due to financial eligibility limits. This approval shifts the demonstration’s budget neutrality model from an aggregate cap to a per member per month model. The demonstration is effective through January 31, 2030.
  • Nevada
    • On December 13, Nevada submitted its 1115 demonstration titled, “Reentry Demonstration Waiver.” The state seeks authority to provide healthcare and behavioral health services to individuals who are incarcerated for up to 90 days prior to the individual’s anticipated date of release. Nevada aims to improve health outcomes and reduce recidivism through access to stable and continuous care. The federal public comment period is open until January 29, 2025.
  • Pennsylvania
    • On December 26, CMS approved Pennsylvania’s new 1115 demonstration titled, “Keystones of Health.” The state receives authority to provide limited coverage for eligible incarcerated individuals for up to 90 days prior to the individual’s anticipated date of release from state prison or county jail. This approval also provides expenditure authority for certain housing and nutrition-related services to eligible Medicaid beneficiaries based on clinical and social risk criteria. The demonstration is effective through December 31, 2029.
  • Vermont
    • On January 2, CMS approved an amendment to Vermont’s 1115 demonstration titled, “Global Commitment to Health.” The state receives authority to provide health-related social needs services and infrastructure support; close the Substance Use Disorder (SUD) Community Intervention and Treatment (CIT) coverage gap; expand Developmental Disabilities Services benefits; and support the transition of Community Rehabilitation and Treatment (CRT) and Mental Health Under 22 services to the Medicaid state plan. CMS also granted approval for several HRSN attachments to allow the state to claim Federal Financial Participation (FFP) for HRSN expenditures. The demonstration is effective through December 31, 2027.
  • Wisconsin
    • On December 16, Wisconsin submitted a request to amend its 1115 demonstration titled, “BadgerCare Reform Demonstration Project.” The state is seeking approval to expand the current authority to reimburse for acute inpatient stays in Wisconsin hospital-based institutions for mental diseases (IMDs) to include Medicaid-enrolled adults aged 12 to 64 who are currently diagnosed with serious mental illness (SMI) or serious emotional disturbance (SED). Current policy provides coverage for members under 21 or over age 64. The state aims to close the gap in coverage and improve access to care for individuals with mental illness. The federal public comment period is open until January 21, 2025.

SPAs

• Administrative SPAs
  • Connecticut (CT-24-0023, effective October 1, 2024): Updates State Plan assurances in accordance with the federally mandated quality reporting requirements for the Child Core Set and the behavioral health quality measures on the Adult Core Set.
  • Wisconsin (WI-24-0023, effective December 31, 2024): Updates State Plan assurances in accordance with the federally mandated quality reporting requirements for the Child Core Set and the behavioral health quality measures on the Adult Core Set
• Eligibility SPAs
  • Iowa (IA-25-0001, effective January 1, 2025): Provides for 12 months of continuous postpartum coverage to eligible individuals enrolled in Medicaid.
• Payment SPAs
  • Texas (TX-24-0028, effective October 1, 2024): Updates the Early Periodic, Screening, Diagnosis, and Treatment (EPSDT) program fee schedule.
• Services SPAs
  • Maine (ME-24-0028, effective October 25, 2024): Removes electronic visit verification (EVV) for hospice services.