1115 MassHealth Demonstration ("Waiver") Amendment Request (Submitted to CMS October 16, 2023)
- Demonstration Amendment Request Submitted to CMS: PDF | Word
- Fact Sheet: PDF | Word
- Budget Neutrality Workbook Submitted to CMS: PDF | Excel
- Public Comments to Proposed MassHealth Section 1115 Demonstration ("Waiver") Amendment Request: PDF | Word
Public Comment Period:
EOHHS will accept comments on the request to provide temporary housing assistance and supportive services for families and pregnant individuals, including newly arrived immigrants, who are enrolled MassHealth members and who are eligible for Massachusetts’ Emergency Assistance family shelter program (see pp. 12-14) through November 29, 2023.
Written comments may be delivered by email or mail. By email, please send comments to 1115WaiverComments@mass.gov and write “1115 Amendment Comments” in the subject line. By mail, please send comments to: 1115 Amendment Comments, EOHHS Office of Medicaid, One Ashburton Place, 3rd Floor, Boston, MA 02108. Comments must be received by November 29, 2023 to be considered.
August 2, 2023
On August 2, 2023, Massachusetts announced its intent to submit a request to CMS to amend the MassHealth Section 1115 Demonstration. The Amendment Request outlines the specific authorities being requested from CMS to advance health equity by expanding coverage and further addressing members’ health-related social needs.
- Demonstration Amendment Request: PDF | Word
- Public Notice: PDF | Word
- Fact Sheet: PDF | Word
- Budget Neutrality Workbook: PDF | Excel
Public Comment Period:
EOHHS will accept comments on the proposed amendment through September 9, 2023. Written comments may be delivered by email or mail. By email, please send comments to 1115WaiverComments@mass.gov and write “1115 Amendment Comments” in the subject line. By mail, please send comments to: 1115 Amendment Comments, EOHHS Office of Medicaid, One Ashburton Place, 3rd Floor, Boston, MA 02108. Comments must be received by September 9, 2023 to be considered.
EOHHS will hold a virtual public meeting to hear comments from the public on the proposed amendment:
Date: Thursday, August 17, 2023
Time: 2:00 to 3:00 PM
Meeting Link: Join from PC, Mac, Linux, iOS or Android: https://umassmed.zoom.us/j/94557067013?pwd=enp6UFBIdWRBNDNDbnBlU3Q3bXhJUT09
Password: 828333
Or iPhone one-tap (US Toll): +13052241968,94557067013# or +13092053325,94557067013#
Or Telephone:
Dial:
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Meeting ID: 945 5706 7013
Password: 828333
International numbers available: https://umassmed.zoom.us/u/adZdMvQp4y
Reasonable Accommodation: If you require an ADA accommodation, please contact 1115WaiverComments@mass.gov
Currently Approved 1115 MassHealth Demonstration ("Waiver")
The Commonwealth of Massachusetts’ current 1115 Demonstration (Project Number II-W-00030/I) Extension was approved on September 28, 2022, effective October 1, 2022 through December 31, 2027. Technical Corrections were approved June 21, 2023.
June 21, 2023
- MassHealth Technical Corrections Approval: PDF | Word
- Waiver and Expenditure Authorities: PDF | Word
- STCs MassHealth 1115 Waiver Extension: PDF | Word
- STC Attachments (will be posted as they are approved by CMS):
- Attachment A. Preparing the Evaluation Design, CMS resource: PDF | Word
- Attachment B. Preparing the Interim and Summative Evaluation Reports, CMS resource: PDF | Word
- Attachment D. SUD Health IT Plan, approved 3/1/23: PDF | Word
- Attachment E. Safety Net Care Pool Payments, approved 5/19/23: PDF | Word
- Attachment F. SMI/SED Implementation Plan, approved 3/1/23: PDF | Word
- Attachment G. SUD and SMI/SED Monitoring Protocol, approved 11/3/23 - Part A: XLS Part B: PDF | Word
- Attachment J. Hospital Quality and Equity Initiative (HQEI) Implementation Plan, PY1 approved 5/19/23: PDF | Word
- Attachment L. Pricing Methodology for Accountable Care Organizations (ACOs) and Managed Care Organizations (MCOs), approved 6/21/23 PDF | Word
- Attachment M. DSRIP Protocol, approved 6/21/23: PDF | Word
- Attachment N. Safety Net Hospital Provider Payment Eligibility and Allocation Protocol, approved 3/29/23: PDF | Word
- Attachment O. Continuous Eligibility Implementation Plan, approved 5/19/23: PDF | Word
- Attachment Q. Medicaid Managed Care Entity/ACO Performance-Based Payment, Mechanisms , approved 5/19/23: PDF | Word
- Attachment R. DSRIP Flexible Services Protocol, approved 9/2/21: PDF | Word
- Attachment T. Health Related Social Needs (HRSN) Implementation Plan, approved 6/12/23: PDF | Word
- Attachment V: Medicare vs. Medicaid Provider Rate Attestation Table: PDF | Word
September 28, 2022
- MassHealth Demonstration Approval: PDF | Word
- Demonstration Approval Fact Sheet: PDF | Word
- 1115 MassHealth Demonstration Extension Summary: PDF | Word
Approval of 2017-2022 Close Out Report
Approval of Interim Evaluation Report – September 29, 2022
Amendment of 1115 MassHealth Demonstration ("Waiver") – August 11, 2022
On August 11, 2022, CMS approved Massachusetts' amendment requests related to serious mental illness and serious emotional disturbance (SMI/SED), Community Support Program services for individuals with justice involvement (CSP-JI), and Medicare cost-sharing assistance (MSP).
Approval of Temporary 1115 Demonstration Extension by CMS (June 9, 2022 – September 30, 2022)
Centers for Medicare and Medicaid Services Expenditure Authority: PDF | Word
Centers for Medicare and Medicaid Services Special Terms & Conditions: PDF | Word
Centers for Medicare and Medicaid Services Special Waivers List: PDF | Word
Find the letter from CMS approving the temporary extension of the 1115 Waiver: PDF | Word
For more information about the request to extend the 1115 Demonstration, please see: 1115 MassHealth Demonstration ("Waiver") Extension Request
1115 MassHealth Demonstration ("Waiver") Amendment Request (Filed June 8, 2021, updated June 17, 2021)
- Section 1115 Demonstration ("Waiver") Amendment Request Submitted to CMS: (PDF) | (Word)
- Public Comments to Proposed MassHealth Section 1115 Demonstration ("Waiver") Amendment Request: (PDF) | (Word)
Draft 1115 MassHealth Demonstration ("Waiver") Amendment Request (as posted for public comment March 23, 2021)
The public-comment period closed on April 25, 2021.
- 1115 MassHealth Demonstration (“Waiver”) Amendment Public Notice: PDF | Word
- 1115 MassHealth Demonstration (“Waiver”) Amendment Request: PDF | Word
- 1115 MassHealth Demonstration (“Waiver”) Amendment Summary: PDF | Word
- MassHealth 1115 Demonstration ("Waiver") Amendment Public Meeting Slides - March 31, 2021: PDF | Word | PPT
On May 23, 2019, CMS approved Massachusetts’ amendment request related to post-eligibility treatment of income for veteran annuities. On June 26, 2019 CMS approved technical corrections related to this amendment approval. Please see approval letters for a more detailed list of the edits included.
- 1115 MassHealth Demonstration (“Waiver”) Amendment Approval Letter 5-23-19: PDF | Word
- 1115 MassHealth Demonstration (“Waiver”) Technical Corrections Approval Letter 6-26-19: PDF | Word
- 1115 MassHealth Demonstration (“Waiver”) Expenditure Authority 06-26-19: PDF | Word
- 1115 MassHealth Demonstration (“Waiver”) Waiver List 06-26-19: PDF | Word
- 1115 MassHealth Demonstration (“Waiver”) STC 06-26-19: PDF | Word
1115 MassHealth Demonstration ("Waiver") Evaluation Design – January 31, 2019
- 1115 MassHealth Demonstration (“Waiver”) Evaluation Design Approval Letter: PDF | Word
- 1115 MassHealth Demonstration (“Waiver”) Evaluation Design: PDF | Word
1115 MassHealth Demonstration ("Waiver") Revised Evaluation Design – March 30, 2021
- 1115 MassHealth Demonstration ("Waiver") Revised Evaluation Design Approval Letter: PDF | Word
- 1115 MassHealth Demonstration (“Waiver”) Revised Evaluation Design: PDF | Word
Technical Corrections of 1115 MassHealth Demonstration ("Waiver") – October 23, 2018
On October 23, 2018, CMS approved a number of technical corrections throughout Massachusetts' Demonstration documents. Please see approval letter for a more detailed list of the edits included.
- 1115 MassHealth Demonstration (“Waiver”) Technical Corrections Approval Letter 10-23-18: PDF | Word
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1115 MassHealth Demonstration (“Waiver”) Expenditure Authority 10-23-18: PDF | Word
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1115 MassHealth Demonstration (“Waiver”) Waiver List 10-23-18: PDF | Word
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1115 MassHealth Demonstration (“Waiver”) STC 10-23-18: PDF | Word
Amendment of 1115 MassHealth Demonstration ("Waiver") – June 27, 2018
On June 27, 2018, CMS approved Massachusetts' amendment request related to veteran annuities.
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1115 MassHealth Demonstration (“Waiver”) Amendment Approval Letter 6-27-18: PDF | Word
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1115 MassHealth Demonstration (“Waiver”) Expenditure Authority 6-27-18: PDF | Word
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1115 MassHealth Demonstration (“Waiver”) Waiver List 6-27-18: PDF | Word
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1115 MassHealth Demonstration (“Waiver”) STC 6-27-18: PDF | Word
- 1115 MassHealth Demonstration (“Waiver”) Attachments: Zip File | PDF
Amendment of 1115 MassHealth Demonstration ("Waiver") – December 14, 2017
On December 14, 2017, CMS approved Massachusetts’ amendment request related to provisional eligibility and former foster care youth.
1115 Demonstration MassHealth Demonstration ("Waiver") Amendment Request (Filed September 8, 201
Section 1115 Demonstration Amendment Request Submitted to CMS (DOC)
Section 1115 Demonstration Amendment Request Submitted to CMS (PDF)
Public Comments to Proposed MassHealth Section 1115 Demonstration Amendment Request (DOC)
Public Comments to Proposed MassHealth Section 1115 Demonstration Amendment Request (PDF)