The Centers for Medicare & Medicaid Services (CMS) granted an initial approval to the State of Massachusetts for multiple section 1135 flexibilities on March 26, 2020. Your follow-up communication to CMS on April 23, 2020 and September 29, 2020 detai1ed a number of additional federal requirements that also pose issues or challenges for the health care delivery system in Massachusetts and requested a waiver or modification of those additional requirements.

On August 23, 2020, the President of the United States issued a proclamation that Hurricane Laura constitutes an emergency by the authorities vested in him by the Constitution and the laws of the United States, including sections 201 and 301 of the National Emergencies Act (50 U.S.C. 1601 et seq.), and consistent with section 1135 of the Social Security Act (Act).