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The New Review and Approval Process Rule for Section 1115 Medicaid and CHIP Demonstration Waivers

For many years, Section 1115 waivers have been used in the Medicaid program to provide states an avenue to test and implement coverage approaches that do not meet federal program rules, but there have been longstanding concerns about the lack of public input and transparency in the waiver approval process. As a result, the Affordable Care Act required the Department of Health and Human Services to issue regulations designed to ensure that the public has meaningful opportunities to provide input into the Section 1115 waiver process. On February 22, 2012, the Centers for Medicare and Medicaid Services issued final regulations addressing these provisions. This brief provides an overview of the rule.

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.