Dive Insight:
Medicaid waivers, called section 1115 demonstrations, allow states more flexibility to experiment with care delivery in the safety-net insurance program.
Almost every state uses a demonstration waiver, while some states have multiple active waivers. The waivers have allowed states like Alabama to provide family planning services to people whose Medicaid eligibility for pregnancy had ended and Colorado to provide specialized care to people with brain injuries.
The demonstrations account for nearly one-third of all federal Medicaid dollars. Now, regulators are saying they’re going to more strictly oversee spending.
In particular, the CMS’ chief actuary will determine if the demonstrations are budget neutral prior to approval, in compliance with the “Big Beautiful Bill” signed last year.
Source: CMS increases oversight of state Medicaid demonstrations / Healthcare Dive