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florida 1115 waiver

Overview of Florida’s lien waiver rules. On December 15, 2011, CMS agreed to extend the … The state’s original section 1115 demonstration, “Medicaid Reform,” was approved October 19, 2005. Using Section 1115 Demonstrations for Disaster Response; Home & Community-Based Services in Public Health Emergencies; Federal Disaster Resources; Section 1135 Waiver Flexibilities ; Coronavirus Disease 2019 (COVID-19) SPA and 1915 Waiver Processing. The new waivers seeking to impose work or service requirements, as well as others that would impose lifetime coverage limits or premiums, should be fully and carefully … Beginning in 2015, the state implemented … The other Medicaid expansion authority is the Section 1115 research and demonstration waiver. Agency for Health Care Administration . Q1 ’19 Status: The state has submitted an amendment to their approved 1115 waiver, with the public comment period ending Apr. 1115 Family Planning Waiver The family planning waiver provides family planning and family planning-related services to all women o… In this paper we review the Section 1115 … An official website of the United States government, A federal government managed website by theCenters for Medicare & Medicaid Services.7500 Security Boulevard Baltimore, MD 21244, Medicaid Beneficiaries with Complex Care Needs and High Costs, Community Integration Through Long-Term Services and Supports, Using Section 1115 Demonstrations for Disaster Response, Home & Community-Based Services in Public Health Emergencies, Medicaid and CHIP Eligibility & Enrollment Webinars, Affordable Care Act Program Integrity Provisions, Lawfully Residing Immigrant Children & Pregnant Women, Home & Community Based Services Authorities, July 2020 Medicaid & CHIP Enrollment Data Highlights, Medicaid Enrollment Data Collected Through MBES, Performance Indicator Technical Assistance, 1115 Demonstration Monitoring & Evaluation, 1115 Substance Use Disorder Demonstrations, Coronavirus Disease 2019 (COVID-19): Section 1115 Demonstrations, Seniors & Medicare and Medicaid Enrollees, Medicaid Third Party Liability & Coordination of Benefits, Medicaid Eligibility Quality Control Program, State Expenditure Reporting for Medicaid & CHIP, Actuarial Report on the Financial Outlook for Medicaid, Section 223 Demonstration Program to Improve Community Mental Health Services, Medicaid Information Technology Architecture, Medicaid Enterprise Certification Toolkit, Medicaid Eligibility & Enrollment Toolkit, SUPPORT Act Innovative State Initiatives and Strategies, SUPPORT Act Provider Capacity Demonstration, Early and Periodic Screening, Diagnostic, and Treatment, Vision and Hearing Screening Services for Children and Adolescents, Alternatives to Psychiatric Residential Treatment Facilities Demonstration, Testing Experience & Functional Tools demonstration, Medicaid MAGI & CHIP Application Processing Time, Retroactive Eligibility Continuance Letter 2019, CMS Approved DY13 Reimbursement and Funding Methodology, State Attestation – RFMD DY 9 and DY 10 LIP Payment for Physicians, State LIP Cost Reconciliation Report July 2014-June 2015, State LIP UC and IGT Report SFY 2018-SFY 2019, FL MMA LIP and Retroactive Eligibility Amendment Completeness Letter, State Application - FL MMA 1115 LIP and Retroactive Eligibility Amendment, State Application - FL MMA 1115 PDHP Amendment, CMS Approved DY12 Reimbursement and Funding Methodology, FL MMA MEDS-AD and PAC Amendment Approval – December 2017, Amendment Request – MEDS-AD and PAC (09/01/17), MMA Quarterly Report October-December 2016, State Application - Behavioral Health and Supportive Housing Services Amendment, Special Terms and Conditions (7/1/14-06/30/17), CMS Approved DY11 Reimbursement and Funding Methodology (05/20/2016), CMS Approved Reimbursement and Funding Methodology (03/01/2016), CMS Approved Evaluation Design (01/05/2016), CMS Approved Evaluation Design (12/22/2015), LIP Interim Expenditure Authority Letter (06/30/2015), Florida Temporary Extension Request (06/25/2015), Low Income Pool Response Letter (5/26/15), Pending Application - Low Income Pool Amendment (05/26/2015), Pending Application - Express Enrollment Amendment (05/04/2015), Low Income Pool Response Letter (4/15/15), MMA Quarterly Report Jan-Mar 2015 (03/31/2015), MMA Quarterly Report oct-dec 2014 (12/31/2014), Letter Acknowledging the State’s Complete Application (12/04/14), Pending Application - Prescribed Pediatric Extended Care Amendment (11/24/2014), Letter of Approval for Implementation Plan (12/23/13), Approval of Complete Extension Letter (12/12/13), Letter of Recognition of Completed Work (02/20/13), Expenditure Authority (12/16/11-06/30/14), Special Terms and Conditions (12/16/11-06/30/14), Waivers and Authorities (12/16/11-06/30/14), Letter Requesting Amendment to 1115 Demo (08/01/11), Attachment I Amendment Request #1 Overview, Attachment II Replacement Packet/Demo Waiver. The state implemented the demonstration July 1, 2006, in Broward and Duval Counties, and then expanded to Baker, Clay, and Nassau Counties on July 1, 2007. 1915 Waiver Toolkit; CHIP SPA Toolkit; Medicaid SPA Toolkit; … The waiver would initially cover only the elderly population (approximately 43,000 people) but would later … Kansas is denied 1115 waiver for lifetime limits. On May 6, 2019, the Georgia Department of Community Health (DCH) issued a Statement of Need requesting proposals from eligible consulting firms to study, review and analyze waiver opportunities under section 1115 and section 1332 waivers. The State is seeking federal authority to extend Florida’s 1115 Family Planning Waiver (Project Number 11-W-00135/4) for the period January 1, 2018 through December 31, 2022. 1115 Research and Demonstration Waivers • Experimental, pilot, or demonstration projects that promote the objectives of the Medicaid and CHIP programs. States obtain flexibilities in a wide variety of … The Amended State Fiscal Year 2019 appropriations act laid the … 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. MEDS-AD 1115 Research and Demonstration Waiver The program provides assistance for people who are 65 years of age or older or who have a disability, and who have resources below $5,000 for an individual and $6,000 for a couple and whose income at or below 88 percent of the federal poverty level. Wisconsin has a waiver proposal would reduce eligibility for childless adults in its existing waiver program from 200% to 100% FPL. Provides respite, environmental accessibility adaptations, transition case management for medically fragile individuals ages 0 – 20. entitled: MomCare Network; Responsible agency … DSS has developed a draft 1115 waiver application for Medicaid and Medicare eligible (“dually eligible”) individuals who are 65 and older which will supplement a waiver document created by the six New England states. 1115 Managed Medical Assistance Waiver The Managed Medical Assistance program provides primary and acute medical care, and behavioral health and dental services for the majority of Medicaid recipients. The extension of Florida's Section 1115 Medicaid Waiver for … On August 3, 2017, CMS approved its first 1115 waiver under the Trump administration—a five-year extension of Florida’s existing demonstration that reauthorizes its Medicaid managed care program and increases spending authority for its uncompensated care pool. Waivers vary considerably across states, from broad … Section 1115 waiver authority to implement voluntary work referral programs. 1115 Research and Demonstration Waivers • Experimental, pilot, or demonstration projects that promote the objectives of the Medicaid and CHIP programs. Tallahassee, FL 32308 . And, in the coming weeks, CMS is expected to issue its first approval of an 1115 waiver … We also include information on two states—Arizona and Hawaii—with recently expired 1115 … In the 1960s, Section 1115 was added to the Social Security Act and the Medicaid law was passed, providing a mechanism for states to waive certain federal rules as part of a demonstration project. Shortly after the President’s declaration, Florida became the first state to submit a Section 1135 waiver request in response to the COVID-19 national emergency. This brief provides basic information about the purpose and function of Section 1115 waivers, describes the current administration’s waiver priorities, and discusses trends in recent state waiver requests and waiver … Florida's Medicaid Waiver allows the state to provide services not typically covered by Medicaid, while receiving matching federal funds to support patient care. The state submitted a request to extend Florida’s Managed Medicaid Assistance (MMA) program through a CMS section 1115 demonstration waiver. Waiver 1115 Information. This issue brief provides an overview of what Section 1115 Medicaid waivers are, how they are approved and financed, how states have used them, and how they are impacted by health reform. The Section 1115 waiver allows the state to enroll this group, like most other Medicaid coverage groups, into managed care. 766.1115 ... A person who is Medicaid-eligible under Florida law; 2. MMA Waiver Amendment - Overview •The State is seeking federal authority to amend Florida’s 1115 MMA Waiver to: –Implement a pilot program which will provide additional behavioral health services and supportive housing assistance services for Medicaid recipients enrolled in the MMA program. This blog provides an overview of the seven states that use Medicaid 1115 demonstration waivers to fund their Uncompensated Care: California, Florida, Kansas, Massachusetts, New Mexico, Tennessee, and Texas. Three-Year Extension Period (2011-2014): On December 15, 2011, the Agency received approval from CMS to extend Florida’s 1115 Medicaid Reform Waiver for the period July 1, 2011 through June 30, 2014. The Family Planning Waiver operates statewide and provides family planning services to non-pregnant women who meet the eligibility requirements for the waiver… A person who is without health insurance and whose family income does not exceed 200 percent of the federal poverty level as defined annually by … Section 1115 waiver activity is expected to continue both through administrative actions and the courts. This period of active welfare reform and experimentation, accompanied by a rigorous evaluation component, held the promise of an unparalleled opportunity to examine and document the effects of proposed welfare reform measures. The amendment includes reinstatement of the full retroactive coverage period with a … 15, ’19. Support for Medicaid expansion in Kansas came to a halt in February despite efforts from the Senate Public Health and Welfare Committee and House Democrats. CMS Guidance: On March 14, 2017, the CMS sent a letter to state governors that signaled a willingness to use Section 1115 authority to “support innovative approaches to increase employment and community engagement.” On January 11, 2018, CMS … –The amendment … The 1115 demonstration waiver program is intended to fulfill the primary purpose of Medicaid: to provide health care protection to poor and disabled Americans. 1115 MMA Waiver Extension Request . ISSUE: Florida Managed Medical Assistance Program 1115 Waiver (Known at the Department as the Healthy Start Waiver and SOBRA services) Q&A 1 Legislation that became law July 1, 2011, Chapter 409, Part IV, Medicaid Managed Care and more specifically section 409.975, F.S. The purpose of these demonstrations, which give states additional flexibility to design and improve their programs, is to demonstrate and evaluate policy approaches such as: Section 1115 waiver authority has been available to states for decades. Each Section 1115 waiver application required a plan for evaluating the effects of the proposed changes in the AFDC program. Had it been approved, an estimated 150,000 residents would have … The demonstration also provides long-term care services and support (LTSS) to eligible individuals through a managed care delivery system, called DSHP-Plus. The purpose of these demonstrations, which give states additional flexibility to design and improve their programs, is to demonstrate and evaluate … Under this LIP program, Medicaid reimbursement funds were available for services provided to “Medicaid, underinsured and uninsured patients” (§ 1115 … An official website of the United States government, Provides community support coordination, homemaker, personal care, respite, adult dental services, physical therapy evaluation, physical therapy, prescribed drugs, respiratory therapy evaluation, respiratory therapy, skilled nursing, specialized medical equipment and supplies, chore, counseling, home delivered meals, massage therapy, nutritional supplements, personal emergency response system maintenance and monitoring, personal emergency response unit for medically fragile individuals ages 18 no max age, WAIVER TERMINATED 3/31/14 - Provides adult day health care, attendant care, case management, homemaker, respite in-home, consumable medical supplies-enhanced, consumable medical supplies, counseling, OT, personal care, PT, respiratory therapy, skilled nursing, specialized medical equipment/supplies, speech therapy, adult companion, caregiver training/support-group, caregiver training/support-individual, case aide, chore-enhanced, chore, escort, financial risk reduction-assessment, financial risk reduction-maintenance, home accessibility adaptations, home delivered meals, nutritional risk reduction, PERS-installation, PERS-maintenance, pest control-initial visit, pest control-maintenance, physical risk reduction, rehabilitation engineering evaluation, respite-facility-based for aged individuals 65 - no max age, and for physically disabled individuals 18-64 yrs, WAIVER TERMINATED 4/30/10 - Provides adult day health, case management, personal care, respite, incontinence supplies, behavioral assessment/intervention, caregiver training, environmental mods, pharmacy review, wanderer alarm system, wanderer identification and location system for aged individuals 65 yrs - no max age and PD individuals ages 60-64 yrs, WAIVER TERMINATED 3/31/14 - Provides assisted living, case management, incontinence supplies for aged individuals 65 yrs - no max age and PD ages 18-64, WAIVER TERMINATED 3/31/14 - Provides case management, home health aide, personal care, respite, PT, skilled nursing, special medical equipment, special medical supplies, adult companion, adult day health care, chore, environmental accessibility adaptations, family training, financial education and protective services, in-home counseling, OT, PERS, special drug and nutritional assessment, special home delivered meals, speech therapy for aged individuals 65 yrs - no max age, WAIVER TERMINATED 6/30/13 - Provides personal care, residential hab, respite, support coordination, supported employment, adult dental, OT, PT, private duty nursing, respiratory therapy, skilled nursing, specialized medical equipment and supplies, specialized mental health services, transportation, adult day training, behavior analysis services, behavior assistant services, community guide, companion services, dietitian services, environmental accessibility adaptations, in-home support, medication review, PERS, residential nursing, special medical home care, speech therapy, supported living coaching for individuals w/autism, DD, Individuals/w ID ages 3 - no max age, WAIVER TERMINATED 6/30/13 - Provides personal care, residential hab, respite, support coordination, supported employment, adult dental, OT, PT, private duty nursing, respiratory therapy, skilled nursing, specialized medical equipment and supplies, specialized mental health, transportation, adult day training, behavior analysis, behavior assistant, community guide, companion, dietician services, environmental accessibility adaptations, in-home support, medication review, PERS, residential nursing, special medical home care, speech therapy, supported living coaching for individuals w/autism, ID, DD ages 3-no max age, Provides life skills development level 3 - adult day training, residential habilitation, respite, support coordination, adult dental services, occupational therapy, physical therapy, respiratory therapy, skilled nursing, specialized medical equipment and supplies, specialized mental health counseling, speech therapy, transportation, behavior analysis services, behavior assistant services, dietitian services, environmental accessibility adaptations, life skills development level 1 – companion, life skills development level 2 - supported employment, personal emergency response system, personal supports, private duty nursing, residential nursing, special medical home care, supported living coaching for individuals w/autism, ID, DD ages 3 - no max age, Provides respite, support coordination, adult dental services, durable medical equipment, behavioral services, consumable medical supplies, non-residential support services for individuals who are medically fragile ages 3 - 64 years, WAIVER TERMINATED 6/30/2013 - Provides adult day training, respite, support coordination, supported employment, transportation, behavior analysis, behavior assistant, community guide, environmental accessibility adaptations, in-home support, PERS, specialized medical equipment and supplies, supported living coaching for individuals w/ID, autism, DD, ages 3- no max age, Provides adult day health care, case management, homemaker, respite, attendant care, intermittent and skilled nursing, medical equipment and supplies, occupational therapy, personal care, physical therapy, respiratory therapy, speech therapy, transportation, adult companion, assisted living, behavior management, caregiver training, home accessibility adaptations, home delivered meals, medication administration, medication management, nutritional assessment and risk reduction, personal emergency response system (PERS) for aged individuals 65 – no max age, physical disabilities 18-64, and individuals with brain injury, HIV/AIDS/ or medically fragile ages 18-64, WAIVER TERMINATED 3/31/14 - Provides adult day health care, case management, homemaker, personal care, respite, adult companion, assisted living, chore, consumable medical supplies, environmental accessibility adaptions, escort, family training, financial assessment and risk reduction, home delivered meals, nutritional assessment and risk reduction, OT, PERS, PT, respiratory therapy, speech therapy for aged individuals 65 no max age, Provides case management, day health care, homemaker, personal care, skilled nursing care-RN/LPN, specialized medical equipment and supplies, therapeutic management of substance abuse, chore-pest control/other, education and support, environmental accessibility adaptations, home delivered meals, restorative massage, specialized personal care for children in foster care for individuals w/HIV/AIDS ages 0-no max age, Provides residential habilitation, assistive technology, attendant care, behavior programming, community support coordination, consumable medical supplies, occupational therapy, personal adjustment counseling, personal care services, physical therapy, transition case management, companion care, emergency alert response system – installation, emergency alert response system - monitoring and maintenance, environmental accessibility adaptations, life skills training, rehabilitation engineering evaluation, transitional environmental accessibility adaptations for individuals with brain injury ages 18 no max age, A federal government managed website by theCenters for Medicare & Medicaid Services.7500 Security Boulevard Baltimore, MD 21244. Bureau of Medicaid Policy . Kansas Governor, Sam Brownback (R) vetoed the bill. The following waivers are granted under the authority of section 1115(a)(1) of the Social Security Act (“the Act”) to enable the state to continue its Florida Managed Medical Assistance Program section 1115 demonstration (formerly titled “Medicaid Reform”) consistent with the approved Special Terms and … Using Section 1115 Demonstrations for Disaster Response; Home & Community-Based Services in Public Health Emergencies; Federal Disaster Resources; Section 1135 Waiver Flexibilities ; Coronavirus Disease 2019 (COVID-19) SPA and 1915 Waiver Processing. 2727 Mahan Drive, MS #8 . Recipients receive their services through competitively selected health plans. life of the waiver, placing a state at risk for all waiver costs above the cap. A Waiver Amendment (2014): On June 1… The Bethesda plaintiffs are a group of Florida hospitals that challenged the MAC’s exclusion of days in their Medicaid Fractions that are attributable to Florida’s § 1115 Waiver program featuring the Low Income Pool (“LIP”). 1915 Waiver Toolkit; CHIP SPA Toolkit; Medicaid SPA Toolkit; … Medicaid Beneficiaries with Complex Care Needs and High Costs, Community Integration Through Long-Term Services and Supports, Using Section 1115 Demonstrations for Disaster Response, Home & Community-Based Services in Public Health Emergencies, Medicaid and CHIP Eligibility & Enrollment Webinars, Affordable Care Act Program Integrity Provisions, Lawfully Residing Immigrant Children & Pregnant Women, Home & Community Based Services Authorities, July 2020 Medicaid & CHIP Enrollment Data Highlights, Medicaid Enrollment Data Collected Through MBES, Performance Indicator Technical Assistance, 1115 Demonstration Monitoring & Evaluation, 1115 Substance Use Disorder Demonstrations, Coronavirus Disease 2019 (COVID-19): Section 1115 Demonstrations, Seniors & Medicare and Medicaid Enrollees, Medicaid Third Party Liability & Coordination of Benefits, Medicaid Eligibility Quality Control Program, State Expenditure Reporting for Medicaid & CHIP, Actuarial Report on the Financial Outlook for Medicaid, Section 223 Demonstration Program to Improve Community Mental Health Services, Medicaid Information Technology Architecture, Medicaid Enterprise Certification Toolkit, Medicaid Eligibility & Enrollment Toolkit, SUPPORT Act Innovative State Initiatives and Strategies, SUPPORT Act Provider Capacity Demonstration, Early and Periodic Screening, Diagnostic, and Treatment, Vision and Hearing Screening Services for Children and Adolescents, Alternatives to Psychiatric Residential Treatment Facilities Demonstration, Testing Experience & Functional Tools demonstration, Medicaid MAGI & CHIP Application Processing Time, FL Adults with Cystic Fibrosis (0392.R03.00), FL Alzheimers Disease Program (0418.R01.00), FL Channeling for the Frail Elderly (0116.R06.00), FL Familial Dysautonomia Waiver (40205.R03.00), FL Family and Supported Living (Tier 4) (0294.R03.00), FL Traumatic Brain and Spinal Cord Injury (0342.R04.00). 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