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States seek Medicaid flexibilities due to COVID-19 emergency

Sandhya Raman, CQ-Roll Call on

Published in News & Features

WASHINGTON -- States are winning additional Medicaid flexibilities from the Trump administration through special emergency waivers that allow them to better address prevention and treatment of COVID-19.

The waivers allow states to take steps including easing licensing restrictions on new or out-of-state doctors and other providers, and allowing nursing homes or other residential facilities to move patients to alternate settings.

"They are a unique waiver that's only available in the time of a national emergency. They are really helpful because they can give some pretty quick flexibility to states and their Medicaid programs on a whole range of requirements," said Anne Karl, partner at Manatt Health.

So far, the Centers for Medicare and Medicaid Services has approved 16 waivers, including three on Tuesday, related to the coronavirus-based illness known as COVID-19, after President Donald Trump officially declared a national emergency earlier this month.

Beginning with Florida, states started applying for the so-called Section 1135 waivers soon after Trump's announcement.

During the Obama administration, then-Health and Human Services Secretary Kathleen Sebelius urged states to apply for this same type of waiver after the president declared a national emergency due to H1N1 influenza, but the current process has been more detailed and involved, according to experts. CMS released a template earlier this week for states to follow in their waiver applications.


"CMS has been able to swiftly remove barriers and cut red tape for our state partners," CMS Administrator Seema Verma said in a statement. "These waivers give a broad range of states the regulatory relief and support they need to more quickly and effectively care for their most vulnerable citizens."

Matt Salo, executive director of the National Association of Medicaid Directors, told CQ Roll Call that he has not heard of any states that do not intend to apply for the waiver.

"A state can do a lot with these," said Andy Schneider, a research professor at Georgetown University's Center for Children and Families. He noted that the second COVID-19 aid law included language to create a new eligibility group under Medicaid that would allow states to cover coronavirus tests for the uninsured.

States can use a CMS template that streamlines the process to cover this eligibility group.


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