CMS speeds up Medicaid changes for states that apply

CMS is taking steps to streamline the review process for states that apply for section 1915 waivers and state plan amendments, CMS Administrator Seema Verma announced May 7.  

The agency is aiming to make the process more transparent, efficient and less burdensome, according to Verma. Already, CMS has had some results from its efforts, including a 16 percent decrease in the median approval time for Medicaid SPAs from 2016 to 2018. For 1915 waivers, median approval times dropped 11%, while renewal approval times fell 38% and 1915 amendment approval times fell 28% over the same two-year period.

Medicaid serves 72.5 million beneficiaries in the U.S., and most changes to the program are conducted through SPAs and 1915 waivers approved by CMS.

“With faster processing times and earlier communication, states now have much greater ability to manage their programs in an effective and predictable manner,” Verma wrote. “We want to ease bureaucratic requirements for both states and our own staff so that we can focus those resources on improving health outcomes rather than pushing paperwork.”

According to CMS, 78% of SPAs in 2018 were approved within the first 90-day review period, up 14% from 2016. In addition, the backlog of SPA and 1915 waiver actions was cut by 80% from previous years.

CMS has allowed states to make significant changes to their Medicaid programs through waivers since the Trump administration took office. In particular, a handful states have been approved for Medicaid work requirement programs that have resulted in thousands being kicked off their health insurance coverage.

The CMS team tasked with streamlining the waiver process for states was awarded one of the first Gears of Government Awards by the White House Office of Management and Budget.