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.
Waiver application drafts
Application
| Application submitted
| Notes
|
|---|
Children's Extraordinary Needs Waiver application
| 1/18/2024
| If approved, this waiver will allow ODDS to implement
Senate Bill 91. The bill directs us to seek federal approval for a permanent program to pay parents as caregivers. This program is for minor children assessed to have very high medical or behavioral needs.
Thank you to everyone who sent feedback on the draft application.
For print versions, contact us at 503-507-2083 or
odds.waivers@odhsoha.oregon.gov.
|
Fee-for-Service Selective Contracting 1915(b)(4) Waiver amendment
| TBD (February 2024)
| This proposed amendment is administrative. It will add case management projections for the Children’s Extraordinary Needs (CEN) Waiver that was submitted to CMS on Jan. 18, 2024. It does not affect the implementation or programming of the CEN Waiver. The effective date will be July 1, 2024.
|
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 seek public comment on draft applications for the renewal of three current Medicaid model waivers.
These are standard waiver renewals that happen every five years. The revisions will not affect the services individuals receive. The number of individuals served by each waiver will remain the same. The renewals include administrative updates to the waivers' effective dates, service projections and methods used to complete quality assurance activities.
Read the draft waivers:
For print versions: Call 503-507-2083 or email
odds.waivers@odhsoha.oregon.gov.
Here are two ways to submit feedback:
- Send an email to
odds.waivers@odhsoha.oregon.gov.
- Send written comments addressed to:
ODDS Medicaid waiver/State Plan analyst
500 Summer Street NE E-09
Salem, OR 97301
Deadline: To be considered, we must receive your feedback by
March 1, 2024.
PLEASE NOTE
This public comment period is
not related to the Children's Extraordinary Needs Waiver. ODDS submitted that waiver's application to the Centers for Medicare and Medicaid Services (CMS) last month.