1115 Transparency Requirements

The Affordable Care Act requires opportunity for public comment and greater transparency of the section 1115 demonstration projects. A Final Rule, effective on April 27, 2012, establishes a process for ensuring public input into the development and approval of new section 1115 demonstrations as well as extensions of existing demonstrations. This Final Rule sets standards for making information about Medicaid and CHIP demonstration applications and approved demonstration projects publicly available at the State and Federal levels. The Final Rule ensures that the public will have an opportunity to provide comments on a demonstration while it is under review at CMS. At the same time, the Final Rule ensures that the development and review of demonstration applications will proceed in a timely and responsive manner.

States must provide at least a 30-day public notice and comment period for applications for new demonstrations and extensions of existing demonstrations. Once a State’s 30-day public comment period has ended, the State will submit an application to CMS. Within 15 days of receipt of the application, CMS will determine whether the application is complete. CMS will send the State written notice informing the State of receipt of the complete application, the date on which the Secretary received the application, and the start date of the 30-day Federal public notice period. If CMS determines that the application is not complete, CMS will notify the State of any missing elements in the application.

After the State is notified that their application is complete, there will be a 30-day Federal comment period for the general public and stakeholders to submit comments. CMS will not act on the demonstration request until 15 days, at a minimum, after the conclusion of the public comment period. CMS will continue to accept comments beyond the 30-day period; however, CMS cannot guarantee that comments received after the 30-day comment period will be considered due to the need for timely Federal review of a State's request. Therefore, CMS strongly encourages comments to be submitted within the 30-day Federal comment period.

In October 2015, CMCS released the first report to Congress, as required by the Affordable Care Act, on actions taken with respect to demonstration projects submitted under section 1115(a) of the Social Security Act. This first report to Congress provides a comprehensive history of federal public notice and comment policies applied to state Medicaid and CHIP demonstration projects and highlights federal transparency actions taken on state applications for 1115 demonstrations through September 2015. See the report to Congress.

PRA Disclosure Statement. According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0938-1162 (Expires: TBD). As discussed in the collection’s Supporting Statement, the time required to complete this information collection is estimated to range from 4 to 400 hours per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this collection, please write to: CMS, 7500 Security Boulevard, Attn: PRA Reports Clearance Officer, Mail Stop C4-26-05, Baltimore, Maryland 21244-1850.