Section 1115 of the Social Security Act gives the Secretary of Health and Human Services authority to approve experimental, pilot, or demonstration projects that promote the objectives of the Medicaid and CHIP programs. The purpose of these demonstrations, which give States additional flexibility to design and improve their programs, is to demonstrate and evaluate policy approaches such as: Expanding eligibility to individuals who are not otherwise Medicaid or CHIP eligible Providing services not typically covered by Medicaid Using innovative service delivery systems that improve care, increase efficiency, and reduce costs. In general, section 1115 demonstrations are approved for a five-year period and can be renewed, typically for an additional three years. Demonstrations must be “budget neutral” to the Federal government, which means that during the course of the project Federal Medicaid expenditures will not be more than Federal spending without the waiver.
There are almost one hundred 1115 Waivers in use nationwide, however, this map only identifies the active waivers that pertain to PCMH initiatives. For a comprehensive list of approved 1115 waivers, click here.
