What is a 1915 waiver?

Waivers. Enacted in the same 1981 legislation as Section 1915(b) freedom-of-choice waivers, Section 1915(c) allows states to obtain waivers of comparability requirements, in order to offer home- and community-based services (HCBS) to limited groups of enrollees as an alternative to institutional care.

What is the difference between Medicaid and Medicaid waiver?

Medicaid also offers Home and Community Based Services (HCBS), which are programs that provide services to individuals who live outside of nursing homes. Waivers are state specific Medicaid programs that allow for services to be provided outside of nursing homes.

What is innovation waiver?

The Innovations Waiver is a home and community-based Medicaid program. It provides services and supports to individuals with intellectual and/or developmental disabilities who are at risk being placed in an institution.

What is a managed care waiver?

1915(a) Waiver Basics States can implement a voluntary managed care program simply by executing a contract with companies that the state has procured using a competitive procurement process. CMS must approve the state in order to make payment.

How do Medicaid waiver programs work?

Medicaid waivers help pay for standard medical and non-medical care, including personal care services, respite care, and adult daycare. People who do not qualify for a Medicaid waiver program may still be eligible for help from resources such as the PACE or SSI.

What is an assisted living waiver?

The Assisted Living Waiver (ALW) is a Home and Community-Based Services (HCBS) waiver that was created by legislation that directed the California Department of Health Care Services (DHCS) to develop and implement the project to test the efficacy of assisted living as a Medi-Cal benefit.

What is Cardinal Innovations Medicaid?

Cardinal Innovations Healthcare is a specialty Medicaid health plan for behavioral health care and intellectual or developmental disabilities.

How does a 1115 waiver work?

Section 1115 permits the Secretary to allow states to use federal Medicaid and CHIP funds in ways that federal rules do not otherwise allow, as long as the Secretary determines that the initiative is an “experimental, pilot, or demonstration project” that “is likely to assist in promoting the objectives of the program. …

How many states have Medicaid Waivers under 1915?

Of these states, 35 offer 1915 (c) waivers, which are Medicaid waivers authorized by Section 1915 of the Social Security Act that allow states to provide certain services to specific populations. The numbers in parentheses that follow each state indicate how many 1915 (c) waivers that state has.

What does a 1915 ( I ) HCB waiver mean?

1915 (i) HCBS waivers This waiver, which may be provided under a state’s Medicaid plan, allows the state to provide certain HCBS to people who have incomes lower than 150% of the Federal Poverty Level and do not need to live in a facility to receive care.

What are the different types of Medicaid waivers?

State Medicaid Plans and Waivers. 1 HCBS 1915 waiver programs. Through certain waivers, states can target services to people who need LTSS. These waivers are called home- and 2 1915 (c) HCBS waivers. 3 1915 (i) HCBS waivers. 4 1915 (j) self-directed personal assistance services. 5 1915 (k) Community First Choice.

What is 1915 K community first choice Medicaid?

This option expands Medicaid opportunities for the provision of home and community-based LTSS, facilitates community integration, and provides an enhanced federal match of six additional percentage points. Read Medicaid.gov’s overview of 1915 (k) Community First Choice.