As of March 25th, CMS has approved 23 states 1135 Medicaid waivers, giving the state more flexibility with its Medicaid program suspending pre-authorizations and allowing Medicaid beneficiaries to seek care in alternative settings, including settings that are not licensed via Medicaid. These waivers are effective until the official withdrawal of the public emergency.
States can individually pursue the following actions for Medicaid and CHIP programs through 1135 waivers:
• Waive prior authorization requirements in fee -for-service programs
• Permits providers located out of state/territory to provide care to another state’ s
Medicaid enrollees impacted by the emergency
• Temporarily suspend certain provider enrollment and revalidation requirements to increase access to care.
• Temporarily waive requirements that physicians and other health care professionals be licensed in the state in which they
are providing services, so long as they have an equivalent licensing in another state, and
• Temporarily suspend requirements for certain pre -admission and annual screenings for nursing home residents
• States and territories are encouraged to assess their needs and request these available flexibilities, which are more
completely outlined in the Medicaid and CHIP Disaster Response Toolkit.
For more information and to access the toolkit, visit:
This post was first published April 1, 2020 and was updated July 29, 2020.