The Role of Section 1915(b) Waivers in Medicaid Managed Care

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March 2017

States have repeatedly raised concerns about the administrative burdens associated with Medicaid waivers; this presentation asks whether policymakers should consider programmatic changes to transition Section 1915(b) waiver authority for Medicaid managed care to state plan authority.

The presentation reviews and compares Section 1915(b) waiver authority to state plan authority under Section 1932 and Section 1115 waiver authority. Section 1115 also addresses how states implement comprehensive Medicaid managed care programs but differs from Section 1915(b) regarding the scope of the program that states can implement and the administrative burden associated with implementing each authority. It also addresses the implications of the 2016 Medicaid managed care regulation, which tied requirements to the type of program rather than the authority and eliminated some of the differences in federal oversight and monitoring of waivers.

The presentation concludes with policy issues for the Commission’s consideration.

Publication Type: Presentations

From: March 2017 MACPAC Public Meeting

Tags: 1915(b) freedom of choice waivers, managed care, Section 1115 research and demonstration project waivers