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Diane Publishing Books
Medicaid Demonstration Waivers: Approval Process Raises Cost Concerns and Lacks Transparency
Katherine Iritani (au)
Medicaid, a $436 billion federal and state health care program for low-income individuals and families, is a significant and growing expenditure. Section 1115 of the Social Security Act authorizes the Secretary of Health and Human Services (HHS) to waive certain Medicaid requirements and allow otherwise uncovered costs for demonstration projects that are likely to promote Medicaid objectives. By HHS policy, these demonstrations should be budget neutral, that is, not increase federal spending over what it would have been if the stateäó»s existing program had continued. States estimate what their spending would have been without the demonstration, and HHS approves a spending based on projected spending. This report reviewed HHS approval of recent Medicaid section 1115 demonstrations. It examined (1) the purpose of new demonstrations, and (2) the extent to which HHSäó»s policy and process for reviewing proposed demonstration spending provide assurances that federal costs will not increase. Tables and figure. This is a print on demand report.
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