1115 Research and Demonstration Waiver Extension Request

Legislative Directive

On April 30, 2010, the Florida Legislature passed Senate Bill 1484 and Governor Crist signed the bill into law (Chapter 2010-144, Laws of Florida) on May 28, 2010. Within this bill, the Florida Legislature directed the Agency to seek approval of a 3 year waiver extension in order to continue operation of the 1115 waiver in Baker, Broward, Clay, Duval and Nassau Counties. The Agency was directed to submit the extension request by no later than July 1, 2010.

Public Meetings

The Agency held a series of public meetings (provided in link below) to solicit public input on the extension of Florida’s 1115 Research and Demonstration Waiver (Medicaid Reform) as authorized by the Florida Legislature.  The agenda items for the public meetings included: description of the legislation passed during the 2010 Florida Legislative Session which impacts the waiver, an overview of the existing waiver, and a description of the draft extension request.  There was an opportunity for public comment during the meetings. The location, date and time of the public meetings that were held is provided in the link below. In addition, the Agency accepted written comments on the draft extension request via mail or email. Supplemental information regarding the demonstration is provided below.

Extension Request Submitted

On June 30, 2010, the Agency submitted a 3-year waiver extension request to the Centers for Medicare and Medicaid Services.  The waiver extension request was submitted as specified in SB 1484.  The waiver extension request can be viewed by clicking on the link below.  If you have comments, please submit them to the Agency via mail or email (see below).

Federal and State Correspondence after Extension Request Submission

On August 17, 2010, the Centers for Medicare and Medicaid Services (CMS) advised the Agency that they would review and process the State’s request to renew the Reform Demonstration under section 1115(a) authority, rather than under section 1115(e) authority as originally requested by the State.

August 17, 2010 Letter from CMS [PDF 531KB]

Q: Does this mean that federal CMS has denied the state’s request for extension of the Medicaid Reform Waiver?

A: No, the request has not been denied.  CMS has simply notified the state that they will process the request under the section 1115(a) authority.  This authority would allow CMS to request changes/ amendments to the terms and conditions of the waiver.  Please note the last sentence of the letter from CMS which states “We look forward to working with the State in the coming months toward renewing the Florida Medicaid Reform Demonstration.”

Q: Does this mean that action on the extension/ renewal of the Medicaid Reform Waiver will be delayed?

A: Under 1115(a), there is no prescribed timeframe by which CMS must process a waiver request. At this point, the state does not anticipate that a review under the (a) authority would impact waiver operations and the original waiver does not expire until June 30, 2011.  While there is no formal processing timeframe, the State will work with CMS to facilitate timely review.

On December 16, 2010, the Agency received a letter from CMS requesting additional information on Florida’s 1115 waiver extension request.  Please click on the link below to view this letter.

December 16, 2010, Letter from CMS – Request for Additional Information [PDF 87KB]

On January 11, 2011, the Agency responded to the letter from CMS requesting additional information on Florida’s 1115 waiver extension request.  Please click on the links below to view the Agency’s response and attachments.

January 11, 2011, Response to CMS – Request for Additional Information [PDF 1.85KB]

Attachments I – XVIII for January 11, 2011, Response to CMS – Request for Additional Information

On January 31, 2011, Florida Governor Rick Scott sent a letter to Secretary Sebelius of the Department of Health and Human Services regarding the waiver extension request.  Please click on the link below to view this letter.

January 31, 2011, Letter to Secretary Sebelius from Florida Governor Rick Scott [PDF 463KB]

On March 29, 2011, the Agency provided CMS 90-days advance notice regarding the Medicaid Reform Waiver’s expansion statewide as authorized by the Florida Legislature.   Please click on the link below to view this letter.

March 29, 2011, Letter to CMS – Regarding FL Legislature’s Intent to Expand 1115 Medicaid Reform Waiver [PDF 695KB]

On April 28, 2011, the Agency received a letter from CMS regarding the Agency’s letter of March 29, that provided 90-days advance notice of the program’s expansion statewide as authorized by the Florida Legislature.  Please click on the link below to view this letter.

April 28, 2011, Letter from CMS – Regarding FL Legislature’s Intent to Expand 1115 Medicaid Reform Waiver [PDF 68KB]

On June 20, 2011, the Agency submitted a 30 day temporary extension request to CMS as the waiver expires on June 30, 2011.  This temporary extension will ensure continued service delivery to Medicaid recipients and provide additional time for the State and the Centers for Medicare and Medicaid Services to finalize the waiver extension.

June 20, 2011, Letter to CMS – 30 Day Temporary Waiver Extension Request [PDF 42KB]

On June 28, 2011, the Agency received a letter from CMS approving the Agency’s request for a 30 day temporary extension of the waiver that was scheduled to expire on June 30, 2011.  The Demonstration will be temporarily extended through July 31, 2011.  This temporary extension will ensure continued service delivery to Medicaid recipients and provide additional time for the State and the Centers for Medicare and Medicaid Services to finalize the waiver extension.

June 28, 2011, Letter from CMS – Approval of 30 Day Temporary Waiver Extension Request [PDF 455KB]

On July 29, 2011, the Agency submitted a 14 day temporary extension request to CMS as the waiver expires on July 31, 2011.  This temporary extension will ensure continued service delivery to Medicaid recipients and provide additional time for the State and the Centers for Medicare and Medicaid Services to finalize the waiver extension.

July 29, 2011, Letter to CMS – 14 Day Temporary Waiver Extension Request [PDF 262KB]

On July 29, 2011, the Agency received a letter from CMS approving the Agency’s request for a 14-day temporary extension of the waiver that was scheduled to expire on July 31, 2011.  The Demonstration will be temporarily extended through August 14, 2011.  This temporary extension will ensure continued service delivery to Medicaid recipients and provide additional time for the State and the Centers for Medicare and Medicaid Services to finalize the waiver extension.

July 29, 2011 – Letter from CMS – Approval of 14-day Temporary Waiver Extension Request [PDF 78KB]

On August 12, 2011, the Agency submitted a temporary extension request to CMS through the end of August as the waiver is scheduled to expire on August 14, 2011.  This temporary extension will ensure continued service delivery to Medicaid recipients and provide additional time for the State and the Centers for Medicare and Medicaid Services to finalize the waiver extension.

August 12, 2011, Letter to CMS – Temporary Waiver Extension Request [PDF 234KB]

On August 12, 2011, the Agency received a letter from CMS approving the Agency’s request for a 17-day temporary extension of the waiver that was scheduled to expire on August 14, 2011.  The Demonstration will be temporarily extended through August 31, 2011.  This temporary extension will ensure continued service delivery to Medicaid recipients and provide additional time for the State and the Centers for Medicare and Medicaid Services to finalize the waiver extension.

August 12, 2011, Letter from CMS – Approval of 17-day Temporary Waiver Extension Request [PDF 83KB]

On August 31, 2011, the Agency submitted a temporary extension request to CMS through September 15, 2011, as the waiver is scheduled to expire on August 31, 2011.  This temporary extension will ensure continued service delivery to Medicaid recipients and provide additional time for the State and the Centers for Medicare and Medicaid Services to finalize the waiver extension.

August 31, 2011, Letter to CMS – Temporary Waiver Extension Request [PDF 285KB]

On September 1, 2011, the Agency received a letter from CMS, dated August 31, 2011, approving the Agency’s request for a 15-day temporary extension of the waiver that was scheduled to expire on August 31, 2011.  The Demonstration will be temporarily extended through September 15, 2011.  This temporary extension will ensure continued service delivery to Medicaid recipients and provide additional time for the State and the Centers for Medicare and Medicaid Services to finalize the waiver extension.

August 31, 2011, Letter from CMS – Approval of 15-day Temporary Waiver Extension Requests [PDF 84KB]

On September 13, 2011, the Agency submitted a temporary extension request to CMS through September 30, 2011, as the waiver is scheduled to expire on September 15, 2011.  This temporary extension will ensure continued service delivery to Medicaid recipients and provide additional time for the State and the Centers for Medicare and Medicaid Services to finalize the waiver extension.

September 13, 2011, Letter to CMS – Temporary Waiver Extension Request [PDF 212KB]

On September 15, 2011, the Agency received a letter from CMS approving the Agency’s request for a 15-day temporary extension of the waiver that was scheduled to expire on September 15, 2011.  The Demonstration will be temporarily extended through September 30, 2011.  This temporary extension will ensure continued service delivery to Medicaid recipients and provide additional time for the State and the Centers for Medicare and Medicaid Services to finalize the waiver extension.

September 15, 2011, Letter from CMS – Approval of 15-day Temporary Waiver Extension Request [PDF 84KB]

On September 29, 2011, the Agency submitted a temporary extension request to CMS through October 15, 2011, as the waiver is scheduled to expire on September 30, 2011.  This temporary extension will ensure continued service delivery to Medicaid recipients and provide additional time for the State and the Centers for Medicare and Medicaid Services to finalize the waiver extension.

September 29, 2011, Letter to CMS – Temporary Waiver Extension Request [PDF 296KB]

On September 30, 2011, the Agency received a letter from CMS approving the Agency’s request for a 15-day temporary extension of the waiver that was scheduled to expire on September 30, 2011.  The Demonstration will be temporarily extended through October 15, 2011.  This temporary extension will ensure continued service delivery to Medicaid recipients and provide additional time for the State and the Centers for Medicare and Medicaid Services to finalize the waiver extension.

September 30, 2011, Letter from CMS – Approval of 15-day Temporary Waiver Extension Request [PDF 83KB]

On October 12, 2011, the Agency submitted a temporary extension request to CMS through October 31, 2011, as the waiver is scheduled to expire on  Saturday, October 15, 2011.  This temporary extension will ensure continued service delivery to Medicaid recipients and provide additional time for the State and the Centers for Medicare and Medicaid Services to finalize the waiver extension.

October 12, 2011, Letter to CMS – Temporary Waiver Extension Request [PDF 274KB]

On October 14, 2011, the Agency received a letter from CMS approving the Agency’s request for a 16-day temporary extension of the waiver that was scheduled to expire on Saturday, October 15, 2011.  The Demonstration will be temporarily extended through Monday, October 31, 2011.  This temporary extension will ensure continued service delivery to Medicaid recipients and provide additional time for the State and the Centers for Medicare and Medicaid Services to finalize the waiver extension.

October 14, 2011, Letter from CMS – Approval of 16-day Temporary Waiver Extension Request [PDF 84KB]

On October 26, 2011, the Agency submitted a temporary extension request to CMS through November 15, 2011, as the waiver is scheduled to expire October 31, 2011.  This temporary extension will ensure continued service delivery to Medicaid recipients and provide additional time for the State and the Centers for Medicare and Medicaid Services to finalize the waiver extension.

October 26, 2011, Letter to CMS – Temporary Waiver Extension Request  [PDF 277KB]

On October 31, 2011, the Agency received a letter from CMS approving the Agency’s request for a 15-day temporary extension of the waiver that was scheduled to expire on October 31, 2011.  The Demonstration will be temporarily extended through November 15, 2011.  This temporary extension will ensure continued service delivery to Medicaid recipients and provide additional time for the State and the Centers for Medicare and Medicaid Services to finalize the waiver extension.

October 31, 2011, Letter from CMS – Approval of 15-day Temporary Waiver Extension Request [PDF 84KB]

On November 10, 2011, the Agency submitted a temporary extension request to CMS through November 30, 2011, as the waiver is scheduled to expire on November 15, 2011.  This temporary extension will ensure continued service delivery to Medicaid recipients and provide additional time for the State and the Centers for Medicare and Medicaid Services to finalize the waiver extension.

November 10, 2011, Letter to CMS – Temporary Waiver Extension Request [PDF 256KB]

On November 14, 2011, the Agency received a letter from CMS approving the Agency’s request for a 15-day temporary extension of the waiver that was scheduled to expire on November 15, 2011.  The Demonstration will be temporarily extended through November 30, 2011.  This temporary extension will ensure continued service delivery to Medicaid recipients and provide additional time for the State and the Centers for Medicare and Medicaid Services to finalize the waiver extension.

November 14, 2011, Letter from CMS Approval of 15-day Temporary Waiver Extension Request [PDF 80KB]

On November 23, 2011 the Agency submitted a letter dated November 22, 2011 requesting a temporary extension to CMS through December 15, 2011, as the waiver is scheduled to expire on November 30, 2011.  This temporary extension will ensure continued service delivery to Medicaid recipients and provide additional time for the State and the Centers for Medicare and Medicaid Services to finalize the waiver extension.

November 22, 2011, Letter to CMS – Temporary Waiver Extension Request  [PDF 251KB]

On November 29, 2011, the Agency received a letter from CMS approving the Agency’s request for a 15-day temporary extension of the waiver that was scheduled to expire on November 30, 2011.  The Demonstration will be temporarily extended through December 15, 2011.  This temporary extension will ensure continued service delivery to Medicaid recipients and provide additional time for the State and the Centers for Medicare and Medicaid Services to finalize the waiver extension.

November 29, 2011, Letter from CMS Approval of 15-day Temporary Waiver Extension Request [PDF 80KB]


Please mail comments and suggestions to:
1115 Medicaid Reform Waiver
Office of the Deputy Secretary for Medicaid
Agency for Health Care Administration
2727 Mahan Drive, MS #8
Tallahassee, Florida 32308
You may also email your comments and suggestions to
medicaidreform@ahca.myflorida.com

To receive announcements regarding Florida’s 1115 Research and Demonstration Waiver, you may request to be added to the interested parties list by filling in your contact information on the Florida Medicaid Reform Pilot webpage.

If you previously joined the Medicaid Reform Interested Parties Email List, please note that information will be sent to this list via mass email.  Your email server may recognize this as Spam or Junk Mail, and therefore some action may be required on your part to receive notices from Medicaid Reform.