Key documents related to the GA 1135 waiver for COVID-19 Response are included in this post.
Tag: 1135 waivers
Gov. Kemp, DCH Announce Approval of 1135 Medicaid and PeachCare for Kids® Waiver | Governor Brian P. Kemp Office of the Governor
Gov. Kemp, DCH Announce Approval of 1135 Medicaid and PeachCare for Kids® Waiver
April 02, 2020
Atlanta, GA – Governor Brian P. Kemp and the Georgia Department of Community Health (DCH) today announced that the Centers for Medicare and Medicaid Services (CMS) approved Georgia’s section 1135 waiver request on the temporary checklist, granting the state a number of flexibilities for Medicaid and PeachCare for Kids® providers and members to combat the COVID-19 public health emergency. To read the approval letter, click HERE.
“We want to thank CMS for granting this waiver to provide the resources and flexibility for our health care systems and heroic health care workers to fight COVID-19,” said Governor Kemp. “The safety of Georgians is my top priority, and this measure helps ensure access to health care for some of our state’s most vulnerable citizens during this unprecedented time.”
“The Department of Community Health is grateful to our federal partners for moving so quickly to provide regulatory relief and support to our health care systems,” said DCH Commissioner Frank Berry. “We also greatly appreciate the work of our providers in helping us to explore creative avenues to ensure the best care to our citizens.”
Included in the approval of template checklist flexibilities under the 1135 waiver are:
Temporary suspension of Medicaid fee-for-service prior authorization requirements for particular benefits
Extension of pre-existing prior authorizations
Suspension of Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II assessments for 30 days
Extension of state fair hearing requests and appeal timelines
Authorization for Georgia Medicaid to provisionally, temporarily enroll out-of-state providers who are enrolled in another state’s Medicaid program or Medicare
Waiver of application fees, criminal background checks, site visits and in-state licensure requirements for providers not already enrolled in another state’s Medicaid program or Medicare
Authorization for Georgia Medicaid to temporarily cease re-validation of providers
Authorization for the provision of services in alternative settings
The approval of these temporary flexibilities is effective retroactively to March 1, 2020 and ends upon termination of the public health emergency, including any extensions, according to CMS.
Additional provisions requested in Georgia’s 1135 waiver are still pending CMS review and approval. Updates will be provided on those pending items as more information becomes available.
CMS Approves Medicaid Section 1135 Waivers for 11 Additional States in Response to COVID-19 | CMS
Press releaseCMS Approves Medicaid Section 1135 Waivers for 11 Additional States in Response to COVID-19
Mar 23, 2020
Today, in keeping with its commitment to ensure states have the necessary tools to respond to the 2019 Novel Coronavirus (COVID-19) pandemic, the Centers for Medicare & Medicaid Services (CMS) approved an additional 11 state Medicaid waiver requests under Section 1135 of the Social Security Act (Act), bringing the total number of approved Section 1135 waivers for states to 13. The waivers were approved within days of states’ submitting them, and offer states new flexibilities to focus their resources on combatting the outbreak and providing the best possible care to Medicaid beneficiaries in their states. These waivers support President Trump’s commitment to operating a COVID-19 response that is locally executed, state managed and federally supported.
These waivers, which were announced earlier today during a White House conference call with the governors, provide relief on a number of fronts, such as prior authorization and provider enrollment requirements, suspending certain nursing home pre-admission reviews, and facilitating reimbursement to providers for care delivered in alternative settings due to facility evacuations.
Today’s approved waivers include the following states:
“Thanks to the decisive leadership of President Trump during this emergency, CMS has been able to swiftly remove barriers and cut red tape for our state partners,” said CMS Administrator Seema Verma. “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.”
On March 13, 2020, President Trump declared the rapidly evolving COVID-19 situation a national emergency, enabling CMS to waive certain requirements in Medicare, Medicaid, and CHIP under section 1135 emergency authority. CMS immediately began accepting and approving state section 1135 Medicaid waiver requests and on March 22, 2020, CMS released an 1135 Medicaid & CHIP Checklist to assist states with their requests.
Examples of waivers available under section 1135 of the Act include:
- Temporarily suspend prior authorization requirements;
- Extend existing authorizations for services through the end of the public health emergency;
- Modify certain timeline requirements for state fair hearings and appeals;
- Relax provider enrollment requirements to allow states to more quickly enroll out-of-state or other new providers to expand access to care, and
- Relax public notice and submission deadlines for certain COVID-19 focused Medicaid state plan amendments, enabling states to make changes faster and ensure they can be retroactive to the beginning of the emergency.
These section 1135 waivers are effective March 1, 2020 and will end upon termination of the public health emergency, including any extensions. Last week, CMS approved COVID-19 related state Medicaid section 1135 waiver requests for Florida and Washington.
These waivers, and earlier CMS actions in response to COVID-19, are part of the ongoing White House Task Force efforts. To keep up with the important work the Task Force is doing in response to COVID-19, visit www.coronavirus.gov. For a complete and updated list of CMS actions, and other information specific to CMS, please visit the Current Emergencies Website.
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