Last month, the Centers for Medicare & Medicaid Services (CMS)
approved the request from the
California Department of Health Care Services (DHCS), for a
12-month extension to the current Section 1115(a) Medicaid
Waiver.
California’s Section 1115(a) Medicaid waiver was scheduled to end
December 31, 2020. The waiver has provided investments to address
social determinates of health and care coordination for our most
vulnerable individuals. California has distinctive county
initiatives such as the Whole Person Care Pilots, which
coordinate primary care, behavioral health and social services
delivering a wide range of wraparound services for California’s
Medi-Cal recipients; Public Hospital Redesign and Incentives in
Medi-Cal (PRIME); and the Drug Medi-Cal Organized Delivery System
(DMC-ODS). Medicaid demonstration waivers have permitted states
and local governments to build infrastructure and extend coverage
and benefits to individuals most. Throughout 2019 DHCS and
stakeholders worked to have California Advancing and Innovating
Medi-Cal (CalAIM), replace the current waiver. As a result of the
COVID-19, CSAC and county partners requested a delay in the
termination of our current waiver and the implementing CalAIM,
while the state, counties, and stakeholders focused on addressing
the pandemic.
DHCS will submitted the request to CMS in the summer of 2020 to
ensure that important programs authorized through Medi-Cal 2020
continue and are eventually transition under CalAIM. CMS
approved the Medi-Cal 2020 Section 1115 demonstration,
through December 31, 2021. This approval authorizes the Special
Terms and Conditions (STCs) of the waiver. CMS and DHCS will work
on continued negotiations for specific aspects of programs under
the Section 1115 Medicaid waiver.
CSAC will continue to engage with DHCS to ensure the
demonstration waivers are utilized to the fullest extent
permitted.
