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1115 Waivers: A Bridge to 2014 for People Living with HIV

1115 Waivers: A Bridge to 2014 for People Living with HIV. Prepared by: Center for Health Law and Policy Innovation, of Harvard Law School & the Treatment Access Expansion Project July 2011. Presentation Outline. Part 1: Background on 1115 Waivers and How They Can Help Your State

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1115 Waivers: A Bridge to 2014 for People Living with HIV

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  1. 1115 Waivers: A Bridge to 2014 for People Living with HIV Prepared by: Center for Health Law and Policy Innovation, of Harvard Law School & the Treatment Access Expansion Project July 2011

  2. Presentation Outline • Part 1: Background on 1115 Waivers and How They Can Help Your State • Part 2: Centers for Medicare and Medicaid (CMS) Guidance • Part 3: Next Steps

  3. 1115 Waivers and the National HIV/AIDS Strategy The Federal Implementation Plan calls on Centers for Medicare and Medicaid Services (CMS) to: “promote and support the development and expedient review of Medicaid 1115 waivers to allow States to expand their Medicaid programs to cover pre-disabled people living with HIV.”

  4. Part 1What Is an 1115 Waiver and How Will It Help My State?

  5. 1115 Waiver = A “Demonstration Project” to Expand Coverage

  6. Examples of 1115 Waivers to Expand Medicaid Coverage

  7. How Will an 1115 Waiver Help My State?

  8. How Will an 1115 Waiver Help My State? Example: North Carolina

  9. How Will an 1115 Waiver Help My State?

  10. How Will an 1115 Waiver Help My State?

  11. Massachusetts ADAP: How Many Are Covered and at What Cost?

  12. Massachusetts ADAP: Expenditures by Category

  13. Massachusetts ADAP: Eligibility (Sept. 2009)

  14. Massachusetts Medicaid HIV ExpansionLine Item Budget Allocation • FY09 $16,591,488 • FY10 $18,078,571 (1,233 enrolled) • FY11 $18,801,714 In addition, MA provides approximately $30M per year in funding to MA DPH to support a broad range of testing, care, treatment and prevention initiatives.

  15. Estimated Cost Saving Associated with HIV Investments Between 1999 and 2008…

  16. Part 2CMS Guidance: What Is It and How Will it Help My State?

  17. What is CMS Doing to “Promote and Support” 1115 Waivers?

  18. How Will the CMS Guidance Help States Put Together Successful Applications? Creative Ways to Demonstrate “Budget Neutrality”

  19. How Will the CMS Guidance Help States Put Together Successful Applications? Creative Ways to Demonstrate “Budget Neutrality”

  20. How Will the CMS Guidance Help States Put Together Successful Applications? Creative Ways to Demonstrate “Budget Neutrality”

  21. 1115 Waiver Is Still a Heavy Lift in Most States

  22. Part 3Next Steps

  23. What You Can Do…

  24. For More Information Treatment Access Expansion Project • Taepusa.org Contact: Amy Killelea, akillelea@law.harvard.edu Dose of Change • Doseofchange.org CMS, State Medicaid Director Letter • https://www.cms.gov/SMDL/SMD/

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