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Pennsylvania Medicaid Coverage Former Foster Care Youth From a Different State & SUD Demonstration

State: Pennsylvania
Waiver Authority:
1115
Status: Approved

Waiver Dates

Approval: 09/29/2017
Effective: 10/01/2017
Expiration: 09/30/2022

Supporting Documents

Approved Application(s) and Related Documents

Date Title
Date   12/15/2020 Title   Demonstration Approval (PDF, 2.6 MB)
Date   06/28/2018 Title   Fact Sheet (PDF, 54.68 KB)

Administrative Record

Date Title
Date   02/12/2021 Title   CMS Letter to State (PDF, 38.65 KB)
Date   12/15/2020 Title   CMS Approved SUD Monitoring Protocol Part A (XLSX, 228.03 KB)
Date   12/15/2020 Title   CMS Approved SUD Monitoring Protocol Part B (PDF, 476.64 KB)
Date   05/22/2020 Title   CMS Approval – SUD Evaluation Design (PDF, 2.64 MB)
Date   05/22/2020 Title   CMS Approved SUD Evaluation Design (PDF, 1.35 MB)
Date   03/04/2020 Title   Quarterly Report October - December 2019 (PDF, 589.21 KB)
Date   03/04/2020 Title   Quarterly Report October - December 2019 - Budget Neutrality Workbook (, 442.68 KB)
Date   12/12/2019 Title   SUD DY2 Q1 Quarterly Report (PDF, 561.58 KB)
Date   12/12/2019 Title   State Annual Report BN Jul 2019–Sept 2019 (, 445.22 KB)
Date   11/27/2019 Title   State Annual Report BN Jul 2018–Jun 2019 (, 426.56 KB)
Date   11/27/2019 Title   State Annual Report Jul 2018–Jun 2019 (PDF, 672.96 KB)
Date   06/13/2019 Title   PA SUD Implementation Plan (PDF, 475.93 KB)
Date   06/13/2019 Title   Quarterly Report January – March 2019 (PDF, 530.47 KB)
Date   04/16/2019 Title   State Draft Evaluation Design (PDF, 621.83 KB)
Date   03/27/2019 Title   FFYC Annual Report October 2017–September 2018 (PDF, 173.72 KB)
Date   03/27/2019 Title   SUD DY1 Q1 & Q2 Quarterly Reports (PDF, 308.34 KB)
Date   06/28/2018 Title   CMS Amendment Approval – SUD Demonstration (PDF, 673.35 KB)
Date   03/23/2018 Title   CMS Amendment Completeness Letter (PDF, 1.06 MB)
Date   03/09/2018 Title   PA SUD Demonstration Amendment application (PDF, 2.24 MB) View Comments
Date   09/29/2017 Title   Original FFCY Demonstration approval (PDF, 278.12 KB)
Date   05/05/2017 Title   State Application for New 1115 (05/05/2017) (PDF, 309.61 KB) View Comments
Date   05/04/2017 Title   CMS Completeness Letter (5/4/2017) (PDF, 1.04 MB)
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