U.S. flag

An official website of the United States government

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 
Appendix K 08/31/2020 CMS Approval 
Amendment 01/19/2021 CMS Approval
Appendix K 04/16/2021 CMS Approval
Appendix K 08/12/2022 CMS Approval
California Advancing and Innovating Medi-Cal (CalAIM) Update to Special Terms and Conditions 07/27/2020 CMS Approval 
Amendment 01/14/2022 CMS Approval 
Update to Special Terms and Conditions and Appendix K 10/09/2020 CMS Approval 
Update to Special Terms and Conditions 03/01/2021 CMS Approval
Update to Special Terms and Conditions 04/05/2021 CMS Approval 
Appendix K 09/08/2022 CMS Approval
Delaware Diamond State Health Plan Appendix K 09/28/2020 CMS Approval
Amendment 11/24/2020 CMS Approval
Appendix K 12/21/2021 CMS Approval
Appendix K 03/10/2022 CMS Approval
Hawaii COVID-19 Public Health Emergency Demonstration New Demonstration 06/25/2020 CMS Approval
Hawaii QUEST Integration Appendix K 03/25/2021 CMS Approval
Appendix K 04/08/2020 CMS Approval 
Appendix K 09/25/2020 CMS Approval 
Healthy Indiana Plan Amendment 07/26/2022 CMS Approval
Iowa Wellness Plan Amendment 1/27/2022 CMS Approval 
Kansas KanCare Amendment 08/15/2022 CMS Approval
Massachusetts MassHealth Update to Special Terms and Conditions 08/06/2020 CMS Approval 
Update to Special Terms and Conditions 11/25/2020 CMS Approval 
Update to Special Terms and Conditions 03/24/2021 CMS Approval
Massachusetts COVID-19 Public Health Emergency (PHE) Demonstration New Demonstration 12/30/2020 CMS Approval
Michigan 1115 Pathway to Integration Amendment 10/27/2020 CMS Approval 
Montana Plan First Amendment 1/14/2022 CMS Approval
New Hampshire COVID-19 Public Health Emergency (PHE) Demonstration New Demonstration 05/29/2020 CMS Approval
New Hampshire Building Capacity for Transformation Update to Special Terms and Conditions 06/12/2020 CMS Approval 
New Jersey FamilyCare Comprehensive Demonstration Appendix K 05/15/2020 CMS Approval
Appendix K 09/25/2020 CMS Approval
Appendix K 09/09/2021 CMS Approval 
Appendix K 05/07/2021 CMS Approval
New Mexico Centennial Care 2.0 1115 Medicaid Demonstration Amendment 03/04/2022 CMS Approval
Appendix K 05/19/2021 CMS Approval
Appendix K 10/09/2020 CMS Approval
Appendix K 05/12/2020 CMS Approval 
New York Medicaid Redesign Team Update to Special Terms and Conditions 08/10/2020 CMS Approval
North Carolina COVID-19 Public Health Emergency Demonstration New Demonstration 06/25/2020 CMS Approval
Rhode Island Comprehensive Demonstration Appendix K 03/24/2020 CMS Approval
Appendix K 05/01/2020 CMS Approval 
Appendix K 05/07/2020 CMS Approval 
Update to Special Terms and Conditions 07/27/2020 CMS Approval
Appendix K 09/03/2020 CMS Approval 
Appendix K 03/17/2021 CMS Approval
Appendix K 09/15/2022 CMS Approval
Rhode Island COVID-19 Public Health Emergency Demonstration New Demonstration 07/21/2020 CMS Approval
Texas Healthcare Transformation and Quality Improvement Program Update to Special Terms and Conditions 08/07/2020 CMS Approval
Amendment 09/03/2020 CMS Approval
Appendix K 04/19/2021 CMS Approval
Tennessee TennCare III Appendix K 06/19/2020 CMS Approval 
Amendment 04/26/2022 CMS Approval
Utah Primary Care Network Update to Special Terms and Conditions 07/17/2020 CMS Approval
Vermont Global Commitment to Health Appendix K 05/22/2020 CMS Approval 
Update to Special Terms and Conditions 06/08/2020 CMS Approval 
Amendment 12/03/2020 CMS Approval
Appendix K 02/24/2022 CMS Approval
Washington COVID-19 Public Health Emergency Demonstration New Demonstration 04/21/2020 CMS Approval
Wisconsin Senior Care Amendment 06/07/2022 CMS Approval