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   02/11/2022 Title   State Acceptance of Managed Care Risk Mitigation COVID-19 amendment (PDF, 170.69 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   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   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   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