Medicaid Waiver

Title XIX of the Social Security Act gives the Secretary of Health and Human Services (HHS) the authority to waive certain federal requirements for states that want to test new or existing methods of delivering services to beneficiaries. Waiver proposals must be “consistent with the purpose of the Medicaid program” (a determination left to the Secretary, who evaluates the request and interprets the statute). All waivers are time-limited and generally cannot increase costs for the Medicaid program. There are multiple types of Medicaid waivers that address different parts of the program and each has unique objectives and requirements stipulated in statute. The most common types of Medicaid waivers are: • 1915(b) managed care waivers • 1915(c) home and community-based services (HCBS) waivers • 1115 demonstration waivers States may concurrently operate multiple waivers—including, in some instances, several of the same waiver type. Every state has at least one Medicaid waiver in place (For list of waivers see, [https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/index.html](https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/index.html))