U.S. flag

An official website of the United States government

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: 09/30/2027

Supporting Documents

Approved Application(s) and Related Documents

Date Title
Date 09/30/2022 Title Demonstration Approval (PDF, 931.69 KB)
Date 01/28/2022 Title Risk Mitigation Approval (PDF, 221.17 KB)
Date 06/28/2018 Title Fact Sheet (PDF, 54.68 KB)

Administrative Record

Date Title
Date 09/12/2023 Title CMS Approved Interim Evaluation Report (PDF, 19.45 MB)
Date 09/01/2023 Title CMS Approved Managed Care Risk Mitigation COVID-19 PHE Evaluation Design (PDF, 335.17 KB)
Date 09/01/2023 Title SUD Mid-Point Assessment (PDF, 775.14 KB)
Date 05/25/2023 Title Approved Monitoring Protocol Part A (XLSX, 154.14 KB)
Date 05/25/2023 Title Approved Monitoring Protocol Part B (PDF, 3.31 MB)
Date 10/12/2022 Title Acceptance Letter (PDF, 133.48 KB)
Date 06/08/2022 Title SUD Quarterly Report January 2022 – March 2022 Part A (XLSX, 786.71 KB)
Date 06/08/2022 Title SUD Quarterly Report January 2022 – March 2022 Part B (PDF, 3.66 MB)
Date 04/08/2022 Title CMS Complete Letter (PDF, 239.05 KB)
Date 03/29/2022 Title State Extension Request (PDF, 13.56 MB) View Comments
Date 03/01/2022 Title SUD Quarterly Report October 2021 – December 2021 Part A (XLSX, 778.13 KB)
Date 03/01/2022 Title SUD Quarterly Report October 2021 – December 2021 Part B (PDF, 3.38 MB)
Date 02/11/2022 Title State Acceptance of Managed Care Risk Mitigation COVID-19 amendment (PDF, 170.69 KB)
Date 12/28/2021 Title SUD Annual Report July 2021 – September 2021 Part A (XLSX, 1.06 MB)
Date 12/28/2021 Title SUD Annual Report July 2021 – September 2021 Part B (PDF, 481.85 KB)
Date 08/30/2021 Title SUD Quarterly Report April 2021 – June 2021 Part A (XLSX, 1.06 MB)
Date 08/30/2021 Title SUD Quarterly Report April 2021 – June 2021 Part B (PDF, 383.5 KB)
Date 07/01/2021 Title Quarterly Report October - December 2020 and Retrospective (Part A) (XLSX, 8.65 MB)
Date 07/01/2021 Title Annual Report October 2019 - September 2020 and Retrospective (Part B) (PDF, 1.08 MB)
Date 07/01/2021 Title SUD Quarterly Report January 2021 – March 2021 Part A (XLSX, 1.05 MB)
Date 07/01/2021 Title SUD Quarterly Report January 2021 – March 2021 Part B (PDF, 408.23 KB)
Date 02/12/2021 Title CMS Letter to State (PDF, 38.65 KB)
Date 01/29/2021 Title Quarterly Report April - June 2020 (Part B) (PDF, 713.15 KB)
Date 01/29/2021 Title Quarterly Report January - March 2020 (Part B) (PDF, 667.71 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 12/15/2020 Title CMS Substance Use Disorder (SUD) Monitoring Protocol Approval (PDF, 2.6 MB)
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 (XLSM, 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 (XLSM, 445.22 KB)
Date 11/27/2019 Title State Annual Report BN Jul 2018–Jun 2019 (XLSM, 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)
« Return to State Waivers List