The Centers for Medicare and Medicaid Services (CMS) has issued an informational bulletin and templates from 2015, that rescind the “fast track” federal review process for section 1115 demonstration Medicaid extensions submitted by states.

Section 1115(a) of the Social Security Act gives the secretary of the Dept. of Health and Human Services authority to approve experimental, pilot, or demonstration projects that are found by the secretary to be likely to assist in promoting the objectives of the Medicaid program.

These demonstrations give states additional flexibility to design and improve their programs and help the federal government and states evaluate state-specific policy approaches to better serve Medicaid populations - including those in SNFs, CMS said.

Now, the agency said no 1115 extensions can apply for a fast-track review because of changes to budget-neutrality requirements. CMS cited the reasons for the changes in a letter last month to state Medicaid directors.

“The overarching goal of CMS’s current approach to budget neutrality is to limit federal financial exposure resulting from the use of section 1115 authority in Medicaid. This existing goal is further bolstered by the WFTC [Working Families Tax Cut] legislation’s requirement to use an actuarially based approach to budget neutrality, which is expected to strengthen fiscal integrity,” the letter from CMS said.

Question or comments? Contact Patrick Connole at pconnole@parkplacelive.com.