Section 1915 authorities allow states to provide home- and community-based services (HCBS) to Medicaid beneficiaries. Operationalizing HCBS programs can be administratively burdensome for states, and MACPAC has engaged in work to identify opportunities to alleviate some of that burden. We proposed policy options at the March 2024 meeting, and based on Commissioner feedback, conducted additional research to better understand the effects of those options. In this session, Commissioners discussed two policy options: (1) increasing the renewal time period for Section 1915(c) waivers from 5 to 10 years, and (2) removing the requirement that states meet a cost neutrality test for Section 1915(c) waivers and directing the Secretary of the U.S. Department of Health & Human Services to release an annual report demonstrating the cost effectiveness of HCBS.
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Medicaid and CHIP Payment and Access Commission
