18
Let’s talk about the Illinois Waiver Proposal
Let’s talk about the Illinois
Waiver Proposal
FIRSTWhat is a Waiver?
and
Why is it important?
No!
Not that kind of Waiver!
No!
Not that kind of Waiver!
This news is about
a Waiver!
BUT…What’s a Waiver?
.
A “WAIVER” is:
an agreement between the federal government and the state that exempts the state from certain provisions of the federal Medicaid law.
Illinois plans to ask the federal government for a Waiver!
BUT,a Waiver of what?
Medicaid Waiver
Medicaid Waiver
AND
Why is that important to Supportive Housing Providers?
A WAIVER of Section 1115 of the Social Security Act concerning Medicaid!
BUT,
What is Section 1115 of the Social Security Act?
What?!?
Medicaid Waiver
Section 1115 is for Research and Demonstration Projects
States can apply for program flexibility to test new or existing approaches to financing and delivering MEDICAID
Medicaid Waiver
Section 1115 of the Social Security Act
gives the Secretary of Health and Human Services authority to approve State proposed
• Experimental projects • Pilot projects, or• Demonstration projects
that promote the objectives of the Medicaid programs
Medicaid Waiver
Section 1115 Demonstrations
• can be approved for years• can be renewed, typically for an
additional years
Demonstrations must be “budget neutral” to the Federal government (less than or equal to what would have been spent in the absence of the waiver)
Medicaid Waiver
States may ask to demonstrate and evaluate policy approaches such as:
• Expanding eligibility to individuals who are not otherwise Medicaid eligible
• Providing services not typically covered by Medicaid
• Using innovative service delivery systems that improve care, increase efficiency, and reduce costs.
Medicaid Waiver
Why is this important to Supportive Housing Providers?
BECAUSE
Medicaid Waiver
Remember:
Illinois recently announced plans to submit a Waiver application in February, 2015.
Medicaid Waiver
AND….
The State has indicated interestedto include:
• supportive housing services and • supportive housing
as covered services under this Waiver application!!!!
Medicaid Waiver
Lots of Questions?
SHPA needs to be actively involved as this Waiver proposal is developed.
Opportunity exists!
Stay tuned!!
Here’s the State’s Plan
Medicaid Waiver
Medicaid Waiver
Waiver Timeline October 18, 2013 - Stakeholder kick-off meeting
November 5, 2013 - Concept paper finalized
December 13, 2013 - First draft of waiver proposal
Oct. 18-Dec. 13, 2013 - Stakeholder meetings
January 5, 2014 - Draft waiver posted for comment
January 15, 2014 - Final waiver w/comments posted
February 15, 2014 - Waiver submitted to CMS 9
