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CMS: NEW – Waivers & flexibilities for health care providers 6.25.20

Click here for the CMS Corona Virus Waivers & Flexibilities.
CMS waivers covid

Coronavirus Waivers & Flexibilities

In certain circumstances, the Secretary of the Department of Health and Human Services (HHS) using section 1135 of the Social Security Act (SSA) can temporarily modify or waive certain Medicare, Medicaid, CHIP, or HIPAA requirements, called 1135 waivers.  There are different kinds of 1135 waivers, including Medicare blanket waivers.  When there's an emergency, sections 1135 or 1812(f) of the SSA allow us to issue blanket waivers to help beneficiaries access care.  When a blanket waiver is issued, providers don't have to apply for an individual 1135 waiver.  When there's an emergency, we can also offer health care providers other flexibilities to make sure Americans continue to have access to the health care they need.

NEW  Waivers & flexibilities for health care providers

Learn how we're easing burden and helping providers care for Americans by offering new waivers and flexibilities:

Read our provider-specific fact sheets on new waivers and flexibilities:

1135 blanket waivers

What do I need to know about 1135 blanket waivers?

If you're an entity in the declared emergency area, you can apply for an 1135 waiver. You'll usually hear back from us within 2-3 days, but if your request is more complicated, it may take up to a week.  If your waiver request has 1 or 2 items, we may get back to you within 24 hours.

Once approved, waivers have a retroactive effective date of March 1, 2020 and will end no later than when the emergency declaration's ended.

Waivers don't offer grants or financial assistance.  They also don't allow you to be paid for services that aren't usually covered or for people to be eligible for Medicare who aren't otherwise eligible.  You also shouldn't base your response decisions, like evacuations, on waivers.  Once your waiver's approved, as always to be reimbursed accurately, be sure to keep careful records about the services you provide and the beneficiaries you provide them to.  

1812(f) waiver

Approved Coronavirus 1812(f) waiver (PDF)

Other 1135 waivers & 1915(c) waivers

Waiver resources

Approved states' other Coronavirus 1135 waivers

States' other Coronavirus 1135 waivers

Approved states' Coronavirus Home & Community Based (HCBS) 1915(c) Appendix K waivers

States' Coronavirus Emergency Preparedness and Response for HCBS 1915(c) Appendix K waivers

Approved states’ 1115 demonstrations

States' Medicaid Coronavirus 1115 demonstrations

Medicaid State Plan amendments

States' Medicaid State Plan amendments

CHIP State Plan amendments

States' CHIP Plan amendments

Learn more about:

Find general information about waivers and flexibilities.

Page Last Modified: 06/25/2020 04:03 PM

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