This page aggregates tracking information on approved Medicaid emergency authorities to address the COVID-19 Coronavirus emergency. We currently include details on Medicaid Disaster Relief State Plan Amendments (SPAs), other Medicaid and CHIP SPAs, and other state-reported administrative actions; Section 1135 Waivers; and 1915 (c) Waiver Appendix K strategies.
Visit our State Data and Policy Actions COVID-19 Tracker for additional data on state responses to COVID-19, and our special coronavirus topic page for all our resources.
Approved Medicaid Emergency Authorities
Medicaid and CHIP State Plan Amendments and Other State-Reported Administrative Actions to Address COVID-19: This table summarizes changes approved through Medicaid Disaster Relief SPAs and other Medicaid and CHIP SPAs based on approvals posted to Medicaid.gov, and also includes information on state-reported administrative actions to respond to COVID-19 based on review of state Medicaid agency and other state-level websites. CMS has provided a template for states to request approval of Medicaid Disaster Relief State Plan Amendments (SPAs) related to the COVID-19 National Emergency. The Disaster Relief SPA allows states to make temporary changes to their Medicaid state plans and address access and coverage issues during the COVID-19 emergency. States can also make changes through traditional SPAs and can implement changes under existing authority that do not require SPA approval. (Note that some state-reported actions may require SPA approval.) Data under the “Telehealth” header are provided by Manatt Health (for more information see notes below the table). While this table captures state-reported actions taken in response to the COVID-19 emergency, there is considerable variation across states and states may have adopted policy options prior to the emergency that are not reflected here. Any information on state actions that are not identified here can be shared here (please select Medicaid as the topic for comment).
SPA and Other Administrative Actions to Address COVID-19
Section 1135 Waivers to Address COVID-19: If the President has declared an emergency or disaster and the Secretary of Health and Human Services (HHS) has declared a public health emergency, the Secretary can use Section 1135 authority to waive or modify certain Medicare, Medicaid, and CHIP requirements to ensure that sufficient health care items and services are available to meet the needs of Medicaid enrollees in affected areas. On March 13, 2020, President Trump issued a proclamation that the COVID-19 outbreak in the United States constitutes a national emergency, beginning March 1, 2020. After this declaration, the Center for Medicare and Medicaid Services (CMS) issued blanket Section 1135 waivers for many Medicare provisions. Additionally, states are able to submit to CMS for approval Section 1135 waivers for Medicaid provisions. These approved state waivers are summarized in the table below.
Approved Section 1135 Waivers to Address COVID-19
Section 1915 (c) Waiver Appendix K Strategies to Address COVID-19: Most Medicaid home and community-based services (HCBS) are provided through Section 1915 (c) waivers. Other states use Section 1115 to authorize HCBS that could have been provided under Section 1915 (c). States can use Section 1915 (c) waiver Appendix K to amend either of these HCBS waivers to respond to an emergency. For example, states can modify or expand HCBS eligibility or services, modify or suspend service planning and delivery requirements, and adopt policies to support providers. CMS has posted a sample Appendix K template for COVID-19 for COVID-19 waiver amendment requests.
Approved Section 1915 (c) Waiver Appendix K Strategies to Address COVID-19