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CMS Approves First State Request for 1135 Medicaid Waiver in Florida in Response to COVID-19 National Emergency

On March 16th, Florida became the first state to obtain CMS approval of a Section 1135 waiver in response to the COVID-19 National Emergency.  This waiver provides CMS authority to waive certain requirements in Medicare, Medicaid, and CHIP to allow for a wide variety of appropriate Medicaid flexibilities that enable the state to:

  • Waive prior authorization requirements to remove barriers to needed services for beneficiaries with COVID-19,
  • Streamline provider enrollment processes to ensure access to care for beneficiaries with COVID-19,
  • Allow care for beneficiaries with COVID-19 to be provided in alternative settings in the event a facility is evacuated to an unlicensed facility,
  • Suspend certain nursing home screening requirements to provide necessary administrative relief, and
  • Extend deadlines for appeals and state fair hearing requests.

Florida Medicaid issued a Health Care Alert “Medicaid Coverage of Services During the State of Emergency Related to COVID-19” also on March 16th to provide guidance on the flexibilities offered to providers furnishing services to beneficiaries with COVID-19. This policy guidance applies to services (for beneficiaries with COVID-19) rendered through both the fee-for-service (FFS) delivery system and the Statewide Medicaid Managed Care program.

To keep up with the work the Federal government is doing in response to COVID-19 click here For information specific to CMS, visit the Current Emergencies Website.  CMS also released a Virtual Toolkit to help folks stay up-to-date on CMS materials available on COVID-19.  For information specific to SAMHSA, visit the COVID-19 Guidance for Opioid Treatment Programs Website.