by John R. Fischer
, Senior Reporter | January 11, 2018
The Centers for Medicare and Medicaid Services (CMS) has approved a 10-year extension for Mississippi, furthering coverage of family planning services in the state.
The approval is the first ten-year demonstration extension in the organization’s history, expanding eligibility for women and men between 13 and 44 with income of up to 194 percent of the federal poverty level (FPL) who are not enrolled in health insurance coverage, such as Medicaid, Medicare, the Children’s Health Insurance Program (CHIP). The extension follows a series of changes made to the Section 1115 policy, the latest of which was released in November 2017.
“HHS and CMS are committed to working with states to bring additional flexibilities to Medicaid in ways that support both state objectives and the objectives of title XIX of the Social Security Act (the Act),” a CMS spokesperson told HCB News. “The cycle of section 1115 demonstrations – from design, application review, negotiations and approval, to implementation, monitoring, and evaluation – involves substantial time from CMS, other federal partners, and states. To improve the section 1115 demonstration review process, while also assuring adequate federal oversight and evaluation, the Center for Medicaid & CHIP Services (CMCS) is implementing a number of strategies.”
Section 1115 demonstrations, along with waivers, enable states to test new or existing ways for delivering and paying health care services in Medicaid and the Children’s Health Insurance Program (CHIP), in accordance with section 1915 of the Social Security Act.
The changes implemented by CMS aim to reduce regulatory burdens, increase efficiency and promote transparency in the review and approval of Section 1115 demonstration.
The approval in Mississippi enables the state to administer its Medicaid program without having to routinely seek approval to do so from CMS.
In accordance with other changes made to the demonstration’s Special Terms and Conditions (STCs) for the approval and to ensure the presence of adequate federal oversight and evaluation, the state will be required to submit monitoring reports and participate in calls with CMS on an annual basis.
A new streamlined template for annual monitoring and reporting must also be available with assurance that CMS will receive the appropriate information for assessing demonstration outcomes.
“Wherever possible, CMS will work with each state to develop a timeline for the approval process to include a regular schedule of meetings, topics to be discussed and anticipated deliverables,” the spokesperson said. “This will help to ensure states understand the information needed to facilitate the negotiations during the approval process.”
The approval marks the 25th demonstration action approved by CMS since January 21, 2017.