1115 MassHealth Demonstration ("Waiver")

Amendment Request of 1115 MassHealth Demonstration ("Waiver")

Approval of 1115 MassHealth Demonstration ("Waiver") Amendment Request submitted on October 16, 2023 - April 19, 2024

• Demonstration Amendment Approval Letter: PDF | Word
  • Waivers and Expenditures: PDF | Word
  • STCs: PDF | Word
  • Budget Neutrality Workbook: XLS 

1115 MassHealth Demonstration ("Waiver") Amendment Request (March 27, 2024)

On March 27, 2024, 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 5:00 PM on April 26, 2024. Written comments may be delivered by email or mail. By email, please send comments to [e-mail] 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, 3^rd Floor, Boston, MA 02108. Comments must be received by April 26, 2024 in order to be considered.

EOHHS will host a public listening session (both in person and with a virtual option) in order to hear public comments on the Demonstration Amendment. Stakeholders are invited to review the Demonstration Amendment in advance and share with EOHHS staff at the listening session any input and feedback, or questions for future clarification. The listening session is scheduled as follows.

Date:   Monday, April 8, 2024

Time:  4:00 PM – 5:00 PM

Meeting Location:  One Ashburton Place, Boston, MA, 2^nd Floor

Meeting Link:

Join from PC, Mac, Linux, iOS or Android: https://umassmed.zoom.us/j/93228280336?pwd=K1BuVG5BVVhCd1RnQjFjbWdXeDlHZz09

Password: 593985

Or iPhone one-tap (US Toll):  +13092053325,93228280336# or +13126266799,93228280336#

Or Telephone:

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    Meeting ID: 932 2828 0336

    Password: 593985

International numbers available: https://umassmed.zoom.us/j/93228280336?pwd=K1BuVG5BVVhCd1RnQjFjbWdXeDlHZz09 

Reasonable Accommodation: If you require an ADA accommodation for either the in person or virtual option, please contact [e-mail].

Public Meeting on MassHealth 1115 Demonstration Waiver and Delivery System Restructuring Progress

MassHealth will hold a public meeting to present the annual report on the progress of delivery system restructuring efforts and the Delivery System Reform Incentive Program (DSRIP) for calendar year 2021, as well as to provide an opportunity for the public to comment on the progress of the current 1115 MassHealth Demonstration. Stakeholders will have an opportunity to ask questions and provide feedback.  Please see 1115 Demonstration ("Waiver") Reports | Mass.gov for the most recent Annual Report on the 1115 Demonstration. 

Reasonable Accommodation: If you require an ADA accommodation, please contact [e-mail].

Date: Friday, March 1, 2024

Time: 10am - 12pm 

Zoom link:  https://umassmed.zoom.us/j/94607645532?pwd=UW5oUklzSDNkZ3VZN1FIa1BNMnc0UT09

               Password: 510154

               Call in numbers:

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    Meeting ID: 946 0764 5532

    Password: 510154

Community Feedback Forum for Health and Justice

MassHealth recently posted a Notice of Opportunity (NOO) to solicit stakeholders to participate in MassHealth's Community Feedback Forum for Health & Justice. This Forum will advise EOHHS on key policy decisions related to the request for and implementation of its 1115 Demonstration initiative to cover certain MassHealth services for eligible individuals who are incarcerated in a Massachusetts Department of Corrections, County Correctional, or Department of Youth Services facility in the 90-day period before the individuals are released from incarceration.

MassHealth has again updated its Notice of Opportunity (NOO) to participate in MassHealth's Community Feedback Forum for Health & Justice.  The update to the NOO extends the deadline for applications until April 30, 2024, at 4:00PM.

More details can be found in the attached documents, or on COMMBUYS at this link or by searching the keywords “Community Feedback Forum.”

• Second Amended and Restated Community Feedback Forum Notice of Opportunity PDF | Word
• Second Amended and Restated Community Feedback Forum Nomination Form PDF | Word

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 [e-mail] 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, 3^rd Floor, Boston, MA 02108. Comments must be received by November 29, 2023 to be considered.

• Public comments to proposed request to provide temporary housing assistance and supportive services for families and pregnant individuals: PDF | Word

1115 MassHealth Demonstration ("Waiver") Amendment Request (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 [e-mail] 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, 3^rd 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:

    [phone] (US Toll)

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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 [e-mail]

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 S. Evaluation Design Document, approved 1/18/24: 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, approved 11/22/23: PDF | Word

September 28, 2022

• MassHealth Demonstration Approval: PDF | Word
  • Waiver and Expenditure Authorities: PDF | Word
  • STCs MassHealth 1115 Waiver Extension: PDF | Word
• Demonstration Approval Fact Sheet: PDF | Word
• 1115 MassHealth Demonstration Extension Summary: PDF | Word

Approval of 2017-2022 Close Out Report

• Approved Close Out Report: PDF | Word

Approval of Interim Evaluation Report – September 29, 2022

• Approved Interim Evaluation Report: PDF | Word

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).

• Demonstration Amendment Approval Letter: PDF | Word
  • Waiver Authorities: PDF | Word
  • Expenditure Authorities: PDF | Word
  • STCs: PDF | Word

 

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

• 1115 MassHealth Demonstration (“Waiver”) Expenditure Authority 10-23-18: PDF | Word

• 1115 MassHealth Demonstration (“Waiver”) Waiver List 10-23-18: PDF | Word

• 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.

• 1115 MassHealth Demonstration (“Waiver”) Amendment Approval Letter 6-27-18: PDF | Word

• 1115 MassHealth Demonstration (“Waiver”) Expenditure Authority 6-27-18: PDF | Word

• 1115 MassHealth Demonstration (“Waiver”) Waiver List 6-27-18: PDF | Word

• 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 MassHealth Demonstration (“Waiver”) Approval Letter – 12-14-17: PDF | Word

• 1115 MassHealth Demonstration (“Waiver”) – Amended 12-14-17: PDF | Word

See previous Demonstration Waiver documents

1115 Demonstration MassHealth Demonstration ("Waiver") Amendment Request (Filed September 8, 2017)

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)

Last updated:	April 16, 2024