State of Washington COVID-19-Related Section 1115(a) Demonstration Approval

Today, the Centers for Medicare & Medicaid Services (CMS) approved the state of Washington’s COVID-19 Public Health Emergency (PHE) section 1115(a) demonstration, “COVID-19 PHE.”  This approval is the first section 1115(a) demonstration specifically intended to combat the effects of COVID-19 in a state since the President Trump declared the COVID-19 outbreak a national emergency on March 13^th.  Under this demonstration, CMS is providing the state with section 1115(a) waiver and expenditure authorities to assist them in delivering the most effective care to their Medicaid beneficiaries in light of the COVID-19 pandemic. 

In addition to the section 1115(a)(1) waivers which allow the state to target services on a geographic basis; provide flexibilities to vary the amount, duration, and scope of services based on population needs; and to allow Washington to triage access to long-term services and supports (LTSS) based on highest need, the Agency is also providing the state with a variety of section 1115(a)(2) expenditure authorities.  Some of the notable authorities CMS is providing Washington in its COVID-19 PHE demonstration are: 

• Allowing the state to receive federal reimbursement for providing LTSS to beneficiaries, even if they are not timely, updated in the plan of care, or delivered in otherwise-allowable settings;
• Allowing for self-attestation or alternative verification of individuals’ eligibility (income/assets) and level of care (LOC) to qualify for LTSS to reduce administrative burden for both the state and beneficiaries;

• Allowing the state to pay higher rates to certain home and community-based service (HCBS) providers to maintain capacity during the pandemic; and

• Allowing the state to make retainer payments for many providers of habilitation and personal care services to maintain capacity during the emergency.

• Allowing the state to make retainer payments to many providers of personal care services and habilitation services that include personal care as a component.

This approval is another leap forward in cementing CMS’s commitment to providing our state partners with the resources they need during this national pandemic.  It is also another vital step that supports the broader efforts of the White House Coronavirus Task Force. To keep up with the important work that the Task Force is doing in response to COVID-19, please visit: www.coronavirus.gov.  For a complete and updated list of CMS actions, guidance, and other information related to the COVID-19 pandemic, please visit the Current Emergencies Website.  Additionally, CMS has launched a dedicated, Medicaid.gov, COVID-19 resource page that will be continually updated with relevant information for stakeholders.