​1115 HealthChoice Waiver Renewal

GENERAL NOTICE – WAIVER AMENDMENT 

The Centers for Medicare and Medicaid Services (CMS) has authorized the Department’s existing §1115 waiver through December 31, 2021. HealthChoice, first implemented in 1997 under the authority of §1115 of the Social Security Act, is Maryland’s statewide mandatory managed care program for Medicaid enrollees. Under HealthChoice, eligible families and individuals are required to enroll in a managed care organization (MCO) that has been approved by the Department. Each MCO is responsible for ensuring that HealthChoice enrollees have access to a network of medical providers that can meet their health needs.
 
The Maryland Department of Health is postponing a previously announced amendment to its §1115 demonstration waiver (known as HealthChoice) to establish a limited Collaborative Care Pilot.  The open comment period and the two proposed public meetings, the first on November 27, 2018 in Crownsville and the second on December 4, 2018 in Baltimore City, will be rescheduled for a later date.
 
Questions may be sent to the Department via email at mdh.healthchoicerenewal@maryland.gov.
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§1115 Waiver Amendment - July 2, 2018 Submission
 
The Maryland Department of Health (the Department) proposed an amendment to its §1115 demonstration waiver known as HealthChoice, which the Centers for Medicare and Medicaid Services (CMS) has authorized through December 31, 2021. The State’s 30-day public comment period was open from May 21, 2018 through June 19, 2018. The draft waiver amendment application is available here. The final submitted waiver amendment application is available here. An accompanying letter with clarifying details on the Family Planning Program is available here. Hard copies of the application may be obtained by calling (410) 767-5677.
 
Interested parties may send written comments concerning the waiver amendment to Tricia Roddy, Director of Planning, Maryland Medicaid Program, Maryland Department of Health, 201 West Preston Street, Room 224, Baltimore, Maryland 21201 or via email to mdh.healthchoicerenewal@maryland.gov. The Department will accept comments from May 21, 2018 until June 19, 2018.
 
The following public hearings will discuss the content of the waiver amendment and solicit feedback and input from public stakeholders.
 
Baltimore City
Thursday, May 24, 2018; 3PM–5PM (Joint meeting with the HealthChoice Post-Award Forum)
Maryland Department of Health  
201 West Preston Street
Baltimore, Maryland 21201
Room L-1
Webinar Access: To participate in the public hearing remotely, please visit:
 
Audio Conference Line: +1-240-454-0887
Meeting Number (access code): 643 289 553
 
Please click here for the agenda.
Please click here for the presentation.
 
Annapolis
Wednesday, June 6, 2018; 10AM–12PM
Senate Finance Committee Hearing Room
3 East Miller Senate Building
11 Bladen Street
Annapolis, Maryland 21401
 
Please click here for the agenda.
Please click here for the presentation.
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Please click here for information about the Community Health Pilots.

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HealthChoice Post-Award Forums

Per the terms and conditions of Maryland's §1115 HealthChoice demonstration waiver, Maryland must conduct an annual post-award forum to provide the public with the opportunity to offer meaningful comment on the progress of the demonstration. Information about the HealthChoice post-award forums can be found here.

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Effective January 1, 2017, the Centers for Medicare & Medicaid Services (CMS) approved and renewed Maryland's §1115 demonstration waiver, known as HealthChoice, for a period of five years.
 
HealthChoice, first implemented in 1997 under the authority of Section 1115 of the Social Security Act, is Maryland’s statewide mandatory managed care program for Medicaid enrollees. Under HealthChoice, eligible families and individuals are required to enroll in a managed care organization that has been approved by the Maryland Department of Health and Mental Hygiene. Each managed care organization is responsible for ensuring that HealthChoice enrollees have access to a network of medical providers that can meet the health needs of each enrollee.
 
The 2017 extension made the following changes to the demonstration:

  • Created a Residential Treatment for Individuals with Substance Use Disorder (SUD) program as part of a comprehensive SUD strategy;
  • Created two community health pilot programs:
    • Evidence-based Home Visiting Services (HVS) pilot program to provide home visiting services for high-risk pregnant women and children up to two years of age; and
    • Assistance in Community Integration Services (ACIS) pilot program to provide housing-related support services for high-risk, high utilizers who are either transitioning to the community from institutionalization or at high-risk of institutional placement;
  • Raised the enrollment cap for the Increased Community Services program from 30 to 100; and
  • Expanded dental benefits for former foster youth.
 
Application Resources
 
  
Hard copies may be obtained by calling: (410) 767-1439.
For additional information or questions, please email mdh.healthchoicerenewal@maryland.gov.