Waivers
A Medicaid waiver is a provision in Medicaid law through which the federal government "waives" certain rules that normally govern the Medicaid program. When a state applies for a waiver, it asks the federal government for permission to operate its Medicaid program in ways not normally allowed.
Waivers give states flexibility to:
- Design and operate their Medicaid programs.
- Deliver health care services in new ways.
- Reduce costs by using different service strategies.
- Expand coverage to groups of people usually not eligible.
Oregon uses waivers and the K Plan to provide home and community-based services to people who need long-term care. This means they can stay in their own home or other community setting.
K Plan
The
K Plan is a Medicaid state plan option authorized under the Affordable Care Act. It is also called the "1915(k) State Plan" or the "Community First Choice Option." It allows states like Oregon to provide home and community-based attendant services and supports while receiving an increase in federal medical assistance funds for those services.
Oregonians who receive K Plan benefits can still receive Medicaid-funded and non-Medicaid-funded home and community-based supports and long-term care services.
We’re updating two Medicaid waivers. We seek your feedback on our proposed changes by Nov. 25, 2026.
The waivers and changes include:
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1915 (c) Children’s Extraordinary Needs (CEN) Waiver: The update increases the number of children the waiver serves from 155 to 230. The
CEN program is for children under 18 who have very high medical or behavior needs. Parents and guardians are paid to provide care for their child.
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1915 (b) (4) Fee-for-Service Service Selective Contracting Waiver: This update increases the cost projections for CEN case management.
To provide feedback, please read our community update that has a plain language summary of the proposed changes. Here are links to the update in multiple languages: English
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Here are the full draft waivers in English:
For print versions: Call 503-507-2083 or email odds.waivers@odhsoha.oregon.gov.
Here are two ways to submit feedback:
Deadline: To be considered, we must receive your feedback by Nov. 25, 2026.
Next steps: We’ll read through the feedback and consider whether we need to update our drafted changes. We will submit the proposed changes to CMS for approval. We will share a summary of comments and our responses on this web page when we submit the final applications before Jan. 1, 2027.