CMS approves first 10-year waiver extension in Mississippi

Mississippi is the first state to receive a 10-year Section 1115 Medicaid demonstration waiver from the Centers for Medicare and Medicaid Services, CMS announced Thursday.

The waiver will allow the state to provide further coverage of family planning services. It extends eligibility for women and men ages 13 through 44, with incomes up to 194 percent of the federal poverty level who are not enrolled in Medicaid, Medicare, the Children's Health Insurance Program or other creditable health insurance coverage that includes family planning services, CMS said.

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Under Section 1115 of the Social Security Act, the Department of Health and Human Services can waive specific provisions of major health and welfare programs, including certain requirements of Medicaid and CHIP. Waivers are typically approved for a five-year period and can be extended, typically for three years.

New policy to reduce regulatory burden allows Mississippi's program to get a 10-year approval.

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"This is the first ten-year demonstration extension in the history of CMS, and allows Mississippi to administer its Medicaid program without the inconvenience of obtaining routine approvals from CMS," CMS Administrator Seema Verma said.

Mississippi will submit reports and participate in calls with CMS but will have a new streamlined template for annual monitoring.

In a March 14 letter to Governors, the Department of Health and Human Services and CMS announced a new commitment "to empower all states to advance the next wave of innovative solutions to Medicaid's challenges – solutions that focus on improving quality, accessibility, and outcomes in the most cost-effective manner."

Verma tweeted Thursday, "This is the first ten-year waiver in the history of @CMSGov, and allows #Mississippi to help beneficiaries and keep a successful #Medicaid program going without delays, interruptions or routine approvals from Washington."

As of mid-December, there were 34 states with 42 approved waivers and 20 states with 22 pending waivers.

Section 115 Medicaid demonstration waivers give states flexibility to test new approaches in Medicaid that differ from federal program rules, according to a report by the Kaiser Family Foundation. 

Major areas of focus include delivery system reform initiatives, especially efforts that tie provider incentive payments to performance goals; integrating physical and behavioral health or providing enhanced behavioral health services to targeted populations; authorizing the delivery of Medicaid long-term services and supports through capitated managed care; responding to public health emergencies and providing coverage for other targeted groups; and the implementation of alternative ACA Medicaid expansion models, according to the Kaiser report. Increasingly, states are using Section 1115 waivers to combine programs under one single authority.

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com