Here’s a list of approved 1135 waivers submitted by the states and approved by CMS:
Alabama: UPDATED May 8, 2020: Suspends Section 1919(e)7 for pre-admission screening and annual resident review (PASRR) level 1 and level II assessments for 30 days. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Authorization to provisionally, temporarily enroll providers who are enrolled with another SMA or Medicare for the duration of the public health emergency.
Alaska: UPDATED June 15, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Provider enrollment: providers may be provisionally enrollment or re-enrolled as well as use of out-of-state providers is allowed. State fair hearing requests and appeals deadlines are extended through the crisis. Provision of services in alternate settings is granted. Adds tribal consultation for state plan amendment flexibility. Requirement to obtain beneficiary and provider signatures of HCBS Person-Centered Service Plan has been modified. Requirement for face-to-face for home and community based services is waived.
Arizona: UPDATED June 1, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Provider enrollment: providers may be provisionally enrollment or re-enrolled as well as use of out-of-state providers is allowed. CMS is granting authority to permit the state to temporarily authorize reimbursement for home and community-based services (HCBS) provided by an entity that also provides case management services and/or is responsible for the development of the person-centered service plan in circumstances beyond the limited authority provided under regulations. Requirement to obtain beneficiary and provider signatures of HCBS Person-Centered Service Plan has been modified. Requirement for face-to-face for home and community based services is waived.
Arkansas: UPDATED May 5, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Provider enrollment: providers may be provisionally enrollment or re-enrolled as well as use of out-of-state providers is allowed. State fair hearing requests and appeals deadlines are extended through the crisis. There is also a requirement to Obtain Beneficiary and Provider Signatures for the HCBS Person-Centered Service Plan.
California: UPDATED May 8, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Provider enrollment: California currently has the authority to rely upon provider screening that is performed by other State Medicaid Agencies (SMAs) and/or Medicare. As a result, California is authorized to provisionally, temporarily enroll providers who are enrolled with another SMA or Medicare for the duration of the public health emergency. CMS is also approving California’s request to temporarily cease revalidation of providers who are located in California or are otherwise directly impacted by the emergency. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. CMS is granting authority to permit the state to temporarily authorize reimbursement for home and community-based services (HCBS) provided by an entity that also provides case management services and/or is responsible for the development of the person-centered service plan in circumstances beyond the limited authority provided under regulations. Requirement to obtain beneficiary and provider signatures of HCBS Person-Centered Service Plan has been modified.
Colorado: UPDATED June 17, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Extend state Fair Hearing Requests and Appeal Timelines for 120 days. Extends provider enrollment period through the crisis as well as temporarily extends license validation periods. Provision of Services in Alternative Settings allows hospitals and other healthcare facilities to temporarily use alternate settings to deliver care. CMS is allowing the state to modify the deadline for initial and annual level of care determinations required for the 1915(c) HCBS waiver.
Commonwealth of Northern Mariana Islands: April 14, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Provider enrollment: providers may be provisionally enrollment or re-enrolled as well as use of out-of-state providers is allowed. State fair hearing requests and appeals deadlines are extended through the crisis. Provision of services in alternate settings is granted.
Connecticut: UPDATED June 17, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Extends provider enrollment period through the crisis as well as temporarily extends license validation periods. Provision of Services in Alternative Settings allows hospitals and other healthcare facilities to temporarily use alternate settings to deliver care. Requirement to obtain beneficiary and provider signatures of HCBS Person-Centered Service Plan has been modified. CMS is allowing the state to modify the deadline for initial and annual level of care determinations required for the 1915(c) HCBS waiver.
Delaware: UPDATED June 9, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Extend state Fair Hearing Requests and Appeal Timelines for 120 days. Extends provider enrollment period through the crisis as well as temporarily extends license validation periods. Provision of care in an alternate setting is approved.
Florida:March 16, 2020: March 27, 2020 Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Extends provider enrollment period through the crisis as well as temporarily extends license validation periods. Provision of Services in Alternative Settings allows hospitals and other healthcare facilities to temporarily use alternate settings to deliver care.
Georgia: UPDATED May 14, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Provider enrollment: providers may be provisionally enrollment or re-enrolled as well as use of out-of-state providers is allowed. Provision of services in alternate settings is granted.
Hawaii: March 26, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Extends state fair hearing deadlines. Extends provider enrollment period through the crisis as well as temporarily extends license validation periods. Provision of Services in Alternative Settings allows hospitals and other healthcare facilities to temporarily use alternate settings to deliver care.
Idaho: March 26, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Extends provider enrollment period through the crisis as well as temporarily extends license validation periods. Provision of Services in Alternative Settings allows hospitals and other healthcare facilities to temporarily use alternate settings to deliver care.
Illinois: March 23, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Extends state fair hearing requests and appeal timelines for up to 120 days. Extends provider enrollment period through the crisis as well as temporarily extends license validation periods. Provision of Services in Alternative Settings allows hospitals and other healthcare facilities to temporarily use alternate settings to deliver care.
Indiana: UPDATED May 13, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Extends state fair hearing requests and appeal timelines for up to 120 days. Extends provider enrollment period through the crisis as well as temporarily extends license validation periods. Provision of Services in Alternative Settings allows hospitals and other healthcare facilities to temporarily use alternate settings to deliver care. Requirement to obtain beneficiary and provider signatures of HCBS Person-Centered Service Plan has been modified.
Iowa: UPDATED May 5, 2020: Iowa is authorized to provisionally, temporarily enroll providers who are enrolled with another SMA or Medicare for the duration of the public health emergency. Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Provision of services in alternative settings is also granted. 1915(i) HCBS state plan option required timeframe for initial evaluations and assessments, and re-evaluations and reassessments is modified to give the state greater flexibility.
Kansas: March 24, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Extends state fair hearing requests and appeal timelines for up to 120 days. Extends provider enrollment period through the crisis as well as temporarily extends license validation periods.
Kentucky: March 25, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Extends state fair hearing requests and appeal timelines for up to 120 days. Extends provider enrollment period through the crisis as well as temporarily extends license validation periods.
Louisiana: UPDATED May 11, 2020: Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Extends state fair hearing requests and appeal timelines for up to 120 days. Extends provider enrollment period through the crisis as well as temporarily extends license validation periods. Provision of Services in Alternative Settings allows hospitals and other healthcare facilities to temporarily use alternate settings to deliver care. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. CMS is granting authority to permit the state to temporarily authorize reimbursement for home and community-based services (HCBS) provided by an entity that also provides case management services and/or is responsible for the development of the person-centered service plan in circumstances beyond the limited authority provided under regulations. Requirement to obtain beneficiary and provider signatures of HCBS Person-Centered Service Plan has been modified.
Maine: UPDATED May 28, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Provider enrollment: providers may be provisionally enrollment or re-enrolled as well as use of out-of-state providers is allowed. State fair hearing requests and appeals deadlines are extended through the crisis. Provision of services in alternate settings is granted. Adds tribal consultation for state plan amendment flexibility. Requirement to obtain beneficiary and provider signatures of HCBS Person-Centered Service Plan has been modified.
Maryland: UPDATED May 6, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Provider enrollment: providers may be provisionally enrollment or re-enrolled as well as use of out-of-state providers is allowed. Provision of services in alternate settings is granted. Adds tribal consultation for state plan amendment flexibility. Temporarily allow payment for 1905(a) personal care services rendered by legally responsible individuals providing that the state makes a reasonable assessment that the caregiver is capable of rendering such services. CMS approves a waiver to temporarily allow services provided under the 1915(c) HCBS waiver program, the 1915(i) HCBS State plan benefit, and the Community First Choice State plan option at 1915(k) to be provided in settings that have not been determined to meet the home and community-based settings criteria. Requirement to obtain beneficiary and provider signatures of HCBS Person-Centered Service Plan has been modified.
Massachusetts: UPDATED June 16, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Extends state fair hearing requests and appeal timelines for up to 120 days. Extends provider enrollment period through the crisis as well as temporarily extends license validation periods. Provision of Services in Alternative Settings allows hospitals and other healthcare facilities to temporarily use alternate settings to deliver care. Requirement to obtain beneficiary and provider signatures of HCBS Person-Centered Service Plan has been modified. Targeted case management timeline for monitoring and follow-up activities delayed for up to one year.
Michigan:April 6, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Provider enrollment: providers may be provisionally enrollment or re-enrolled as well as use of out-of-state providers is allowed. Provision of services in alternate settings is granted. Adds tribal consultation for state plan amendment flexibility.
Minnesota: UPDATED May 8, 2020: Provision of Services in Alternative Settings allows hospitals and other healthcare facilities to temporarily use alternate settings to deliver care. Extends provider enrollment period through the crisis as well as temporarily extends license validation periods. Temporarily suspend Medicaid fee-for-service prior authorization requirements. State Plan Amendment Flexibilities: Submission Deadline and Public Notice extended beyond March 31, 2020. CMS approves a waiver under section 1135 that allows enrollees to have more than 90 days, up to an additional 120 days for an eligibility or fee for service appeal to request a fair hearing. CMS is granting authority to permit the state to temporarily authorize reimbursement for home and community-based services (HCBS) provided by an entity that also provides case management services and/or is responsible for the development of the person-centered service plan in circumstances beyond the limited authority provided under regulations. Requirement to obtain beneficiary and provider signatures of HCBS Person-Centered Service Plan has been modified.
Mississippi: UPDATED June 1, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Extends state fair hearing requests and appeal timelines for up to 120 days. Extends provider enrollment period through the crisis as well as temporarily extends license validation periods. Provision of Services in Alternative Settings allows hospitals and other healthcare facilities to temporarily use alternate settings to deliver care. Requirement to obtain beneficiary and provider signatures of HCBS Person-Centered Service Plan has been modified.
Missouri: UPDATED May 15, 2020: Provision of Services in Alternative Settings allows hospitals and other healthcare facilities to temporarily use alternate settings to deliver care. Extends provider enrollment period through the crisis as well as temporarily extends license validation periods. Temporarily suspend Medicaid fee-for-service prior authorization requirements. State Plan Amendment Flexibilities: Submission Deadline and Public Notice extended beyond March 31, 2020. CMS approves a waiver under section 1135 that allows enrollees to have more than 90 days, up to an additional 120 days for an eligibility or fee for service appeal to request a fair hearing. Requirement to obtain beneficiary and provider signatures of HCBS Person-Centered Service Plan has been modified.
Montana: March 30, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Extends state fair hearing requests and appeal timelines for up to 120 days. Extends provider enrollment period through the crisis as well as temporarily extends license validation periods. Provision of Services in Alternative Settings allows hospitals and other healthcare facilities to temporarily use alternate settings to deliver care.
Nebraska: UPDATED May 8, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Provider enrollment: providers may be provisionally enrollment or re-enrolled as well as use of out-of-state providers is allowed. State fair hearing requests and appeals deadlines are extended through the crisis. Provision of services in alternate settings is granted. Adds tribal consultation for state plan amendment flexibility. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency.
Nevada: April 7, 2020: Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Provider enrollment: providers may be provisionally enrollment or re-enrolled as well as use of out-of-state providers is allowed. State fair hearing requests and appeals deadlines are extended through the crisis. Provision of services in alternate settings is granted. Adds tribal consultation for state plan amendment flexibility.
New Hampshire: UPDATED May 26, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Extends state fair hearing requests and appeal timelines for up to 120 days. Extends provider enrollment period through the crisis as well as temporarily extends license validation periods. Provision of Services in Alternative Settings allows hospitals and other healthcare facilities to temporarily use alternate settings to deliver care. Requirement to obtain beneficiary and provider signatures of HCBS Person-Centered Service Plan has been modified.
New Jersey: UPDATED June 12, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Extends state fair hearing requests and appeal timelines for up to 120 days. Extends provider enrollment period through the crisis as well as temporarily extends license validation periods. Provision of Services in Alternative Settings allows hospitals and other healthcare facilities to temporarily use alternate settings to deliver care. Requirement to obtain beneficiary and provider signatures of HCBS Person-Centered Service Plan has been modified. Requirement for face-to-face for home and community based services is waived.
New Mexico: March 23, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Extends state fair hearing requests and appeal timelines for up to 120 days. Extends provider enrollment period through the crisis as well as temporarily extends license validation periods. Provision of Services in Alternative Settings allows hospitals and other healthcare facilities to temporarily use alternate settings to deliver care.
New York: UPDATED June 15, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Extends state fair hearing requests and appeal timelines for up to 120 days. Extends provider enrollment period through the crisis as well as temporarily extends license validation periods. Provision of Services in Alternative Settings allows hospitals and other healthcare facilities to temporarily use alternate settings to deliver care. CMS is granting authority to permit the state to temporarily authorize reimbursement for home and community-based services (HCBS) provided by an entity that also provides case management services and/or is responsible for the development of the person-centered service plan in circumstances beyond the limited authority provided under regulations. Requirement to obtain beneficiary and provider signatures of HCBS Person-Centered Service Plan has been modified. Requirement for face-to-face for home and community based services is waived.
North Carolina: March 23, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Extends state fair hearing requests and appeal timelines for up to 120 days. Extends provider enrollment period through the crisis as well as temporarily extends license validation periods. Provision of Services in Alternative Settings allows hospitals and other healthcare facilities to temporarily use alternate settings to deliver care.
North Dakota: UPDATED May 22, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Extends state fair hearing requests and appeal timelines for up to 120 days. Extends provider enrollment period through the crisis as well as temporarily extends license validation periods. Adds tribal consultation for state plan amendment flexibilities. Requirement to obtain beneficiary and provider signatures of HCBS Person-Centered Service Plan has been modified.
Ohio: May 28, 2020: Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Requirement to obtain beneficiary and provider signatures of HCBS Person-Centered Service Plan has been modified.
Oklahoma: UPDATED June 8, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Extends state fair hearing requests and appeal timelines for up to 120 days. Extends provider enrollment period through the crisis as well as temporarily extends license validation periods. State plan amendments will follow tribal consultation before any changes are to be made.
Oregon: UPDATED May 8, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Extends state fair hearing requests and appeal timelines for up to 120 days. Extends provider enrollment period through the crisis as well as temporarily extends license validation periods. Adds tribal consultation for state plan amendment flexibility. Allows the state to modify the deadline for initial and annual level of care determinations required for the 1915(k) state plan benefit, as described in 42 C.F.R. §441.510(c). With this waiver, the initial determination of level of care does not need to be completed before the start of services and the annual level of care determinations that exceeds the 12-month authorization period will remain in place and services will continue until the assessment can occur. CMS is granting authority to permit the state to temporarily authorize reimbursement for home and community-based services (HCBS) provided by an entity that also provides case management services and/or is responsible for the development of the person-centered service plan in circumstances beyond the limited authority provided under regulations. Requirement to obtain beneficiary and provider signatures of HCBS Person-Centered Service Plan has been modified.
Pennsylvania: UPDATED June 9, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Extends state fair hearing requests and appeal timelines for up to 120 days. Extends provider enrollment period through the crisis as well as temporarily extends license validation periods. Provision of Services in Alternative Settings allows hospitals and other healthcare facilities to temporarily use alternate settings to deliver care. Requirement to obtain beneficiary and provider signatures of HCBS Person-Centered Service Plan has been modified. Requirement for face-to-face for home and community based services is waived.
Puerto Rico: April 14, 2020: Provider enrollment: providers may be provisionally enrollment or re-enrolled as well as use of out-of-state providers is allowed. State fair hearing requests and appeals deadlines are extended through the crisis. Provision of services in alternate settings is granted.
Rhode Island: UPDATED May 18, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Extends state fair hearing requests and appeal timelines for up to 120 days. Extends provider enrollment period through the crisis as well as temporarily extends license validation periods.
South Carolina: UPDATED June 15, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Extends state fair hearing requests and appeal timelines for up to 120 days. Extends provider enrollment period through the crisis as well as temporarily extends license validation periods. Adds tribal consultation for state plan amendment flexibility. Requirement to obtain beneficiary and provider signatures of HCBS Person-Centered Service Plan has been modified.
South Dakota: March 24, 2020: Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Provider enrollment: providers may be provisionally enrollment or re-enrolled as well as use of out-of-state providers is allowed. Provision of services in alternate settings is granted.
Tennessee: UPDATED June 9, 2020: Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Extends provider enrollment period through the crisis as well as temporarily extends license validation periods. Provision of Services in Alternative Settings allows hospitals and other healthcare facilities to temporarily use alternate settings to deliver care. Requirement to obtain beneficiary and provider signatures of HCBS Person-Centered Service Plan has been modified.
Texas: UPDATED May 22, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Extends state fair hearing requests and appeal timelines for up to 120 days. Extends provider enrollment period through the crisis as well as temporarily extends license validation periods. CMS is granting authority to permit the state to temporarily authorize reimbursement for home and community-based services (HCBS) provided by an entity that also provides case management services and/or is responsible for the development of the person-centered service plan in circumstances beyond the limited authority provided under regulations. Requirement to obtain beneficiary and provider signatures of HCBS Person-Centered Service Plan has been modified.
Vermont: UPDATED May 28, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Extends state fair hearing requests and appeal timelines for up to 120 days. Extends provider enrollment period through the crisis as well as temporarily extends license validation periods. Provision of Services in Alternative Settings allows hospitals and other healthcare facilities to temporarily use alternate settings to deliver care. Requirement to obtain beneficiary and provider signatures of HCBS Person-Centered Service Plan has been modified.
Virginia: UPDATED May 19, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Extends state fair hearing requests and appeal timelines for up to 120 days. Out-of-state providers for multiple instances of care to multiple participants, so long as the other criteria listed above are met. Provision of services in alternative settings granted. State Plan Amendments (SPAs) deadlines extended.
U.S. Virgin Islands: April 7, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Provider enrollment: providers may be provisionally enrollment or re-enrolled as well as use of out-of-state providers is allowed. State fair hearing requests and appeals deadlines are extended through the crisis.
Utah: UPDATED June 12, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Provider enrollment: providers may be provisionally enrollment or re-enrolled as well as use of out-of-state providers is allowed. State fair hearing requests and appeals deadlines are extended through the crisis. Provision of services in alternate settings is granted. Adds tribal consultation for state plan amendment flexibility. Requirement to obtain beneficiary and provider signatures of HCBS Person-Centered Service Plan has been modified. Requirement for face-to-face for home and community based services is waived.
Washington, D.C. UPDATED May 8, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Provider enrollment: providers may be provisionally enrollment or re-enrolled as well as use of out-of-state providers is allowed. Provision of services in alternate settings is granted. Adds consultation with local authorities for amendment flexibility. CMS is granting authority to permit the state to temporarily authorize reimbursement for home and community-based services (HCBS) provided by an entity that also provides case management services and/or is responsible for the development of the person-centered service plan in circumstances beyond the limited authority provided under regulations. Requirement to obtain beneficiary and provider signatures of HCBS Person-Centered Service Plan has been modified. State fair hearing requests and appeals timelines are extended.
Washington: UPDATED May 6, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Extends state fair hearing requests and appeal timelines for up to 120 days. Extends provider enrollment period through the crisis as well as temporarily extends license validation periods. Adds tribal consultation for state plan amendment flexibilities. Waiver to allow evacuating facilities to provide services in alternative settings, such as a temporary shelter when a provider’s facility is inaccessible. CMS is granting authority to permit the state to temporarily authorize reimbursement for home and community-based services (HCBS) provided by an entity that also provides case management services and/or is responsible for the development of the person-centered service plan in circumstances beyond the limited authority provided under regulations. Requirement to obtain beneficiary and provider signatures of HCBS Person-Centered Service Plan has been modified.
West Virginia: UPDATED June 9, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Extends state fair hearing requests and appeal timelines for up to 120 days. Extends provider enrollment period through the crisis as well as temporarily extends license validation periods. Adds tribal consultation for state plan amendment flexibility. Requirement to obtain beneficiary and provider signatures of HCBS Person-Centered Service Plan has been modified. Requirement for face-to-face for home and community based services is waived.
Wisconsin: UPDATED June 5, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Provider enrollment: providers may be provisionally enrollment or re-enrolled as well as use of out-of-state providers is allowed. Provision of services in alternate settings is granted. Adds tribal consultation for state plan amendment flexibility. Requirement to obtain beneficiary and provider signatures of HCBS Person-Centered Service Plan has been modified.
Wyoming: March 27, 2020: Temporarily suspend Medicaid fee-for-service prior authorization requirements. Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency. Suspend Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days. Extends state fair hearing requests and appeal timelines for up to 120 days. Extends provider enrollment period through the crisis as well as temporarily extends license validation periods. Provision of Services in Alternative Settings allows hospitals and other healthcare facilities to temporarily use alternate settings to deliver care.
