Not all Waivers Are Created Equal:
Importance of State 1135 Waiver Requests to CMS
CMS has granted certain “blanket waivers” as a result of the Novel Coronavirus Disease (COVID19) pandemic. However, it is important to understand that those blanket waivers only pertain to federal requirements. For all impacts and issues governed by Medicaid laws and regulations, States must individually apply to CMS to avail themselves of Section 1135 waivers. Moreover, state-submitted 1135 wavier requests are the best opportunity for states to submit all the “case-by-case” waiver or modification requests as there is no one size fits all solution to mitigating the impact of a global pandemic.
Once granted, these waivers, which require renewal every 60 days, create an opportunity for operators and associations to engage in a mutually beneficial, ongoing dialogue with state agencies to ensure then current needs and issues are being addressed in real-time across both State and Federal law. This continuous line of communication pertaining to 1135 waivers is an opportunity for providers to create a feedback loop with agencies to ensure providers are not only providing insight on issues, but are staying informed enough to stay compliant with state specific regulatory throughout the pendency of COVID-19.
Of note, while not required, CMS recommends that providers notify their local MAC, Regional CMS Office, and state survey agency of intent to operate under Section 1135 waivers for COVID-19.
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State |
Waiver Requested? |
Date of Waiver Request Submission |
Waiver Approved? |
CMS Waiver Response |
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Alabama |
Yes. |
March 18, 2020. |
Yes. |
|
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Alaska |
Pending response from offices/agencies. |
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Arizona |
|
March 17, 2020. |
Yes. |
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Arkansas |
Pending response from offices/agencies. |
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California |
Yes. California Request. |
March 19, 2020. |
Yes. |
|
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Colorado |
Yes. |
March 24, 2020. |
Yes. |
|
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Connecticut |
Yes. |
March 23, 2020 |
Yes. |
|
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Delaware |
Yes. |
March 24, 2020. |
Yes. |
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Florida |
Yes. |
March 13, 2020. |
Yes. |
|
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Georgia |
Yes. |
March 28, 2020. |
Yes. |
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Hawaii |
Yes. |
March 20, 2020. |
Yes. |
|
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Idaho |
Yes. |
March 23, 2020. |
Yes. |
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Illinois |
Yes. |
March 19, 2020. |
Yes. |
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Indiana |
Yes. |
March 19, 2020. |
Yes. |
|
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Iowa |
Yes. |
March 18, 2020. |
Yes. |
Iowa 1135 Waiver Response. |
|
Kansas |
Yes. |
March 20, 2020. |
Yes. |
|
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Kentucky |
Yes. |
March 19, 2010. |
Yes. |
|
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Louisiana |
Yes. |
March 17, 2020. |
Yes. |
|
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Maine |
Maine Department of Health and Human Services confirmed that they are currently evaluating whether to submit a waiver request. |
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Maryland |
|
March 20, 2020. |
Yes. |
|
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Massachusetts |
|
March 20, 2020. |
Yes. |
|
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Michigan |
Michigan Department of Health and Human Services confirmed via email on 3/25 that they are currently not working on an 1135 Waiver Request. |
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Minnesota |
Yes. |
March 23, 2020. |
Yes. |
|
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Mississippi |
Yes. |
March 18, 2020. |
Yes. |
|
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Missouri |
Yes. |
March 20, 2020. |
Yes. |
|
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Montana |
Yes. |
March 26, 2020. |
Yes. |
|
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Nebraska |
Pending response from offices/agencies. |
|
|
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Nevada |
Deputy Administrator, Nevada Department of Health and Human Services, confirmed they are working on the waiver but have not submitted. |
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New Hampshire |
Yes. |
March 19, 2020. |
Yes. |
|
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New Jersey |
Yes. New Jersey Request. |
March 19, 2020. |
Yes. |
|
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New Mexico |
Pending response from offices/agencies. |
March 19, 2020. |
Yes. |
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New York |
|
March 23, 2020. |
Yes. |
|
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North Carolina |
Yes. North Carolina Request. |
March 17, 2020. |
Yes. |
|
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North Dakota |
Yes. North Dakota Request. |
March 18, 2020. |
Yes. |
|
|
Ohio |
Counsel for Ohio Department of Medicaid confirmed that Ohio is currently preparing an 1135 Waiver Request and will be submitting it to CMS soon. |
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Oklahoma |
Yes. |
March 20, 2020. |
Yes. |
|
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Oregon |
Yes. |
March 20, 2020. |
Yes. |
|
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Pennsylvania |
Yes. |
March 24, 2020. |
Yes. |
|
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Rhode Island |
Yes. |
March 16, 2020. |
Yes. |
|
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South Carolina |
Yes. |
March 27, 2020. |
Yes. |
|
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South Dakota |
Yes. |
March 19, 2020. |
Yes. |
|
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Tennessee |
Yes. |
March 27, 2020. |
Yes |
|
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Texas |
|
March 25, 2020. |
Yes. |
|
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Utah |
Utah is currently preparing to submit a waiver request; no estimated date for submission to CMS as of 3/25. |
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Vermont |
Yes. |
March 23, 2020 |
Yes. |
|
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Virginia |
Yes. |
March 16, 2020. |
Yes. |
|
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Washington |
Yes. |
March 15, 2020. |
Yes. |
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West Virginia |
Yes. |
March 23, 2020. |
Yes. |
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Wisconsin |
Pending response from offices/agencies. |
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Wyoming |
Yes. |
March 24, 2020. |
Yes. |
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District of Columbia |
Pending response from offices/agencies. |
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