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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: 09/30/2027

Supporting Documents

Approved Application(s) and Related Documents

Date Title
06/25/2025 Monitoring Redesign Overlay Letter (PDF, 2.52 MB)

Administrative Record

Date Title View
12/10/2024 State Acceptance Letter – 2024 Amendment (PDF, 296.23 KB)
11/14/2024 Amendment Approval – Continuous Eligibility (PDF, 405.66 KB)
09/12/2023 CMS Approved Interim Evaluation Report (PDF, 19.45 MB)
09/01/2023 CMS Approved Managed Care Risk Mitigation COVID-19 PHE Evaluation Design (PDF, 335.17 KB)
09/01/2023 SUD Mid-Point Assessment (PDF, 775.14 KB)
05/25/2023 Approved Monitoring Protocol Part A (XLSX, 154.14 KB)
05/25/2023 Approved Monitoring Protocol Part B (PDF, 3.31 MB)
11/18/2022 Annual Report October 2021 - September 2022 (PDF, 253.49 KB)
10/12/2022 Acceptance Letter (PDF, 133.48 KB)
09/30/2022 Demonstration Approval (PDF, 931.69 KB)
06/08/2022 SUD Quarterly Report January 2022 – March 2022 Part A (XLSX, 786.71 KB)
06/08/2022 SUD Quarterly Report January 2022 – March 2022 Part B (PDF, 3.66 MB)
04/08/2022 CMS Complete Letter (PDF, 239.05 KB)
03/29/2022 State Extension Request (PDF, 13.56 MB) View Comments
03/01/2022 SUD Quarterly Report October 2021 – December 2021 Part A (XLSX, 778.13 KB)
03/01/2022 SUD Quarterly Report October 2021 – December 2021 Part B (PDF, 3.38 MB)
02/11/2022 State Acceptance of Managed Care Risk Mitigation COVID-19 amendment (PDF, 170.69 KB)
01/28/2022 Risk Mitigation Approval (PDF, 221.17 KB)
12/28/2021 SUD Annual Report July 2021 - September 2021 Part A (XLSX, 795.44 KB)
12/28/2021 SUD Annual Report July 2021 – September 2021 Part A (XLSX, 1.06 MB)
12/28/2021 SUD Annual Report July 2021 – September 2021 Part B (PDF, 481.85 KB)
12/20/2021 Annual Report October 2020 – September 2021 (PDF, 172.67 KB)
08/30/2021 SUD Quarterly Report April 2021 – June 2021 Part A (XLSX, 1.06 MB)
08/30/2021 SUD Quarterly Report April 2021 – June 2021 Part B (PDF, 383.5 KB)
07/01/2021 Quarterly Report October - December 2020 and Retrospective (Part A) (XLSX, 8.65 MB)
07/01/2021 Quarterly Report October - December 2020 and Retrospective (Part A) (XLSX, 8.63 MB)
07/01/2021 SUD Annual Report October 2019 - September 2020 and Retrospective (Part B) (PDF, 1.08 MB)
07/01/2021 SUD Quarterly Report January 2021 – March 2021 Part A (XLSX, 1.05 MB)
07/01/2021 SUD Quarterly Report January 2021 – March 2021 Part B (PDF, 408.23 KB)
02/12/2021 CMS Letter to State (PDF, 38.65 KB)
01/29/2021 Quarterly Report April - June 2020 (Part B) (PDF, 713.15 KB)
01/29/2021 Quarterly Report January - March 2020 (Part B) (PDF, 667.71 KB)
12/17/2020 Annual Report - 10/01/2019 - 09/30/2020 (PDF, 250.99 KB)
12/15/2020 CMS Approved SUD Monitoring Protocol Part A (XLSX, 228.03 KB)
12/15/2020 CMS Approved SUD Monitoring Protocol Part B (PDF, 476.64 KB)
12/15/2020 CMS Substance Use Disorder (SUD) Monitoring Protocol Approval (PDF, 2.6 MB)
05/22/2020 CMS Approval – SUD Evaluation Design (PDF, 2.64 MB)
05/22/2020 CMS Approved SUD Evaluation Design (PDF, 1.35 MB)
03/04/2020 Quarterly Report October - December 2019 (PDF, 589.21 KB)
03/04/2020 Quarterly Report October - December 2019 - Budget Neutrality Workbook (XLSM, 442.68 KB)
12/12/2019 SUD DY2 Q1 Quarterly Report (PDF, 561.58 KB)
12/12/2019 State Annual Report BN Jul 2019–Sept 2019 (XLSM, 445.22 KB)
12/06/2019 Annual Report – 10/01/2018 – 09/30/2019 (PDF, 254.37 KB)
11/27/2019 State Annual Report BN Jul 2018–Jun 2019 (XLSM, 426.56 KB)
11/27/2019 State Annual Report Jul 2018–Jun 2019 (PDF, 672.96 KB)
06/13/2019 PA SUD Implementation Plan (PDF, 475.93 KB)
06/13/2019 Quarterly Report January – March 2019 (PDF, 530.47 KB)
04/16/2019 State Draft Evaluation Design (PDF, 621.83 KB)
03/27/2019 FFYC Annual Report October 2017–September 2018 (PDF, 173.72 KB)
03/27/2019 SUD DY1 Q1 & Q2 Quarterly Reports (PDF, 308.34 KB)
06/28/2018 CMS Amendment Approval – SUD Demonstration (PDF, 673.35 KB)
03/23/2018 CMS Amendment Completeness Letter (PDF, 1.06 MB)
03/09/2018 PA SUD Demonstration Amendment application (PDF, 2.24 MB) View Comments
09/29/2017 Original FFCY Demonstration approval (PDF, 278.12 KB)
05/05/2017 State Application for New 1115 (05/05/2017) (PDF, 309.61 KB) View Comments
05/04/2017 CMS Completeness Letter (5/4/2017) (PDF, 1.04 MB)
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