What is a Section 1115 waiver?
A. Section 1115 of the Social Security Act allows the Secretary of the Department of Health and Human Services (HHS) to suspend certain laws or regulations that govern programs authorized by the Social Security Act, such as Medicaid and SCHIP, in the context of a state “research and demonstration project.” A Section 1115 Medicaid or SCHIP demonstration project should “promote the objectives” of the Medicaid program. Some Section 1115 waivers are statewide, comprehensive demonstrations that affect the majority of people who receive Medicaid in that state. These include waivers that require people to enroll in a managed care plan or that expand coverage to all state residents with incomes below a certain level. Other demonstration projects are more limited in scope. Examples of these include waivers that provide family planning services to low-income women who would not otherwise qualify for Medicaid, or those that allow certain people with disabilities to manage their health care purcha
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