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About the Waiver Process

Section 1115 of the Social Security Act allows states to apply for and utilize waivers that allow them to execute or pilot innovative and unique social welfare programs known as “Medicaid demonstration projects.”

These demonstration waivers also boast the possibility of not only influencing policy with the state, but multiple states or the country overall. States are essentially used as laboratories where the operation of unique concepts can be tested and assessed over time, and if the program proves to be successful the state’s model may be adopted by other states and at the federal level.

States apply for waivers by submitting a proposal to the Centers for Medicare and Medicaid services (CMS), part of the United States Department of Health and Human Services.  Waivers are approved for a fixed period of time after which states may reapply for a new waiver reflecting the successes and lessons learned from the original program.

Waivers are submitted to CMS only after a public comment period. CMS is under no timeline to approve or deny state waivers.