Capitol Correspondence - 08.20.18

Administration Claims Federal Review of State Waiver Requests Faster Now

Share this page

According to Bloomberg Government:

“The federal approval process for reviewing changes to states’ Medicaid plans is more efficient now, the Trump administration said Aug. 16.

The Centers for Medicare & Medicaid Services said that between calendar year 2016—the final year of the Obama administration—and the first quarter of 2018, there was a 23 percent decrease in the median approval time for Medicaid state plan amendments or SPAs. But the agency’s streamlined work announced Aug. 16 doesn’t affect the broader waivers—such as imposing work requirements or expanding coverage—that states often seek in the joint state-federal program for the poor. Those broader efforts are known as Section 1115 waivers. 


‘With faster processing times and earlier communication, states now have much greater ability to manage their programs in an effective and predictable manner,’ CMS Administrator Seema Verma said. 

‘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,’ she said.


The CMS announcement follows a November 2017 bulletin from the federal agency announcing an initiative to revamp the reviews.

A representative of a state Medicaid officials group praised the development. Matt Salo, head of the National Association of Medicaid Directors, told Bloomberg Law that any process improvement ‘is a good thing.’ Salo said it saves time and reduces unnecessary bureaucracy.

‘This is definitely a step in the right direction and we look forward to the next steps on this journey, which will include working with CMS on addressing innovative and complex policy issues, especially those in the 1115 waiver arena, as well as figuring out how to leverage already approved SPAs and waivers,’ he said.”