1115 HealthChoice Waiver Renewal

​Background

The Centers for Medicare and Medicaid Services (CMS) has authorized the Maryland Department of Health's (the Department) 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 Department's current §1115 Waiver Special Terms and Conditions can be found here.
 

§1115 Waiver Amendment (2019) - Updated May 16, 2019

The Department has proposed an amendment to its §1115 HealthChoice demonstration waiver to establish a limited Collaborative Care Pilot Program. The State’s 30-day public comment period was open from May 17, 2019 through June 16, 2019. 

The draft waiver amendment is available here; the final waiver amendment (as submitted on June 24, 2019) is available here.
 
Visit the Department's dedicated HealthChoice Collaborative Care Pilot Program webpage for additional information. 
 
---
 
Please click here for more information on the HealthChoice Diabetes Prevention Program.
 
---
 
Archival Information
 
§1115 Waiver Amendment (2018)
  
The Department submitted an amendment to its §1115 demonstration waiver known as HealthChoice on July 2, 2018. The State’s 30-day public comment period was open from May 21, 2018 through June 19, 2018. CMS approved the 2018 waiver amendment in March 2019.
 
§1115 Waiver Amendment Resources (2018)
Baltimore City Public Stakeholder Meeting - May 24, 2018
      - Agenda

      - Presentation

Annapolis Public Stakeholder Meeting - June 6, 2018
      - Agenda
      - Presentation
 
§1115 Waiver Renewal Application (2016-17)

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.
 
§1115 Waiver Renewal Resources (2016-17)
 
 

Please click here for information about the Community Health Pilots.

Please click here for more information on the Adult Dental Pilot Program.

Please click here for more information about the 2018 and 2019 §1115 HealthChoice Post-Award Forums.

  
Hard copies of waiver materials may be obtained by calling: (410) 767-1439.
For additional information or questions, please email mdh.healthchoicerenewal@maryland.gov.