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Coronavirus Disease 2019 (COVID-19): Section 1115 Demonstrations

As part of the U.S. Department of Health and Human Services’ ongoing effort to assist states with addressing the COVID-19 public health emergency, the Centers for Medicare & Medicaid Services (CMS) created a demonstration opportunity under the authority of section 1115(a) of the Social Security Act for states to test a variety of options to deliver the most effective care to their Medicaid beneficiaries as a result of the COVID-19 pandemic.  CMS also developed a standardized section 1915(c) home and community-based services (HCBS) waiver “Appendix K” template to streamline state requests for flexibilities in delivering home and community-based services (HCBS) to Medicaid beneficiaries during the COVID-19 pandemic.  The Appendix K template option is similarly available to states that provide HCBS coverage to beneficiaries under the authority of a section 1115(a) demonstration.  In accordance with these new opportunities, the states listed on this page have approved section 1115(a) demonstration programs to address the particular challenges raised by the COVID-19 pandemic in their state.

State/Demonstration Program Action Approved Approval Date Approval
Arizona Health Care Cost Containment System Appendix K 04/06/2020 CMS Approval (PDF, 886.82 KB) 
Appendix K 08/31/2020 CMS Approval (PDF, 1.06 MB) 
Amendment 01/19/2021 CMS Approval (PDF, 6.38 MB)
Appendix K 04/16/2021 CMS Approval (PDF, 1.37 MB)
California Advancing and Innovating Medi-Cal (CalAIM) Update to Special Terms and Conditions 07/27/2020 CMS Approval (PDF, 408.56 KB) 
Amendment 01/14/2022 CMS Approval (PDF, 264.26 KB) 
Update to Special Terms and Conditions and Appendix K 10/09/2020 CMS Approval (PDF, 290.6 KB) 
Update to Special Terms and Conditions 03/01/2021 CMS Approval (PDF, 337.12 KB)
Update to Special Terms and Conditions 04/05/2021 CMS Approval (PDF, 4.6 MB) 
Delaware Diamond State Health Plan Appendix K 09/28/2020 CMS Approval (PDF, 1.1 MB)
Amendment 11/24/2020 CMS Approval (PDF, 113.89 KB)
Appendix K 12/21/2021 CMS Approval (PDF, 590.11 KB)
Appendix K 03/10/2022 CMS Approval (PDF, 215.35 KB)
Hawaii COVID-19 Public Health Emergency Demonstration New Demonstration 06/25/2020 CMS Approval (PDF, 622.31 KB)
Hawaii QUEST Integration Appendix K 03/25/2021 CMS Approval (PDF, 1.2 MB)
Appendix K 04/08/2020 CMS Approval (PDF, 391.36 KB) 
Appendix K 09/25/2020 CMS Approval (PDF, 971.18 KB) 
Iowa Wellness Plan Amendment 1/27/2022 CMS Approval (PDF, 214.25 KB) 
Massachusetts MassHealth Update to Special Terms and Conditions 08/06/2020 CMS Approval (PDF, 2.05 MB) 
Update to Special Terms and Conditions 11/25/2020 CMS Approval (PDF, 2.08 MB) 
Update to Special Terms and Conditions 03/24/2021 CMS Approval (PDF, 344.66 KB)
Massachusetts COVID-19 Public Health Emergency (PHE) Demonstration New Demonstration 12/30/2020 CMS Approval (PDF, 571.67 KB)
Michigan 1115 Pathway to Integration Amendment 10/27/2020 CMS Approval (PDF, 478.06 KB) 
Montana Plan First Amendment 1/14/2022 CMS Approval (PDF, 286.87 KB)
New Hampshire COVID-19 Public Health Emergency (PHE) Demonstration New Demonstration 05/29/2020 CMS Approval (PDF, 740.25 KB)
New Hampshire Building Capacity for Transformation Update to Special Terms and Conditions 06/12/2020 CMS Approval (PDF, 2.21 MB) 
New Jersey FamilyCare Comprehensive Demonstration Appendix K 05/15/2020 CMS Approval (PDF, 2.06 MB)
Appendix K 09/25/2020 CMS Approval (PDF, 540.53 KB)
Appendix K 09/09/2021 CMS Approval (PDF, 856.19 KB) 
Appendix K 05/07/2021 CMS Approval  (PDF, 452.92 KB)
New Mexico Centennial Care 2.0 1115 Medicaid Demonstration Amendment 03/04/2022 CMS Approval (PDF, 248.54 KB) 
Appendix K 05/12/2020 CMS Approval (PDF, 309.98 KB) 
Appendix K 10/09/2020 CMS Approval (PDF, 407.67 KB)
New York Medicaid Redesign Team Update to Special Terms and Conditions 08/10/2020 CMS Approval (PDF, 4.65 MB)
North Carolina COVID-19 Public Health Emergency Demonstration New Demonstration 06/25/2020 CMS Approval (PDF, 518.41 KB)
Rhode Island Comprehensive Demonstration Appendix K 03/24/2020 CMS Approval (PDF, 546.14 KB)
Appendix K 05/01/2020 CMS Approval (PDF, 722.05 KB) 
Appendix K 05/07/2020 CMS Approval (PDF, 804.72 KB) 
Update to Special Terms and Conditions 07/27/2020 CMS Approval (PDF, 9.51 MB)
Appendix K 09/03/2020 CMS Approval (PDF, 867.95 KB) 
Appendix K 03/17/2021 CMS Approval (PDF, 920.15 KB)
Rhode Island COVID-19 Public Health Emergency Demonstration New Demonstration 07/21/2020 CMS Approval (PDF, 745.7 KB)
Texas Healthcare Transformation and Quality Improvement Program Update to Special Terms and Conditions 08/07/2020 CMS Approval (PDF, 605.62 KB)
Amendment 09/03/2020 CMS Approval (PDF, 646.4 KB)
Appendix K 04/19/2021 CMS Approval (PDF, 448.07 KB)
Tennessee TennCare III Appendix K 06/19/2020 CMS Approval (PDF, 2.03 MB) 
Utah Primary Care Network Update to Special Terms and Conditions 07/17/2020 CMS Approval (PDF, 910.19 KB)
Vermont Global Commitment to Health Appendix K 05/22/2020 CMS Approval (PDF, 607.34 KB) 
Update to Special Terms and Conditions 06/08/2020 CMS Approval (PDF, 500.63 KB) 
Amendment 12/03/2020 CMS Approval (PDF, 2.31 MB)
Appendix K 02/24/2022 CMS Approval (PDF, 536.91 KB)
Washington COVID-19 Public Health Emergency Demonstration New Demonstration 04/21/2020 CMS Approval (PDF, 542.94 KB)