Steps in the 1115 Demonstration Proposal Process
There are five general steps in the life cycle of an 1115 Demonstration Waiver:
- Concept Phase: States present a general outline of their proposal and get
feedback from CMS.
- Proposal Review Phase: a formal proposal is prepared and submitted to CMS
for discussion and review. Federal agencies, including CMS, identify issues and
discuss them with the State in depth. After the State has responded,
negotiations take place. CMS usually develops terms and conditions which
outline the operation of the proposed 1115 waiver.
- Pre-Implementation Phase: this is a time period between federal approval
and actual State start-up of the new program. It usually involves a site visit
by CMS Central Office and/or Regional Office staff to ascertain the State's
degree of readiness to proceed with the proposed demonstration.
- Operational Phase: this is the period the demonstration is live and
delivering services.
- Evaluation Phase: the research and public policy value of the demonstration is evaluated.
FORMAT FOR A SECTION 1115 WAIVER
Because each 1115 proposal is a unique research and demonstration effort designed to allow States flexibility to test new ideas of policy merit, there is no single standardized application format. States generally contact the appropriate CMS Regional Office for assistance. However, in general, an 1115 proposal would present and discuss the following issues: the environment, administration, eligibility, coverage and benefits, delivery system, access, quality, financing issues, systems support, implementation time frames, and evaluation and reporting.
Click here for more information about Statewide 1115 Demonstration Projects
For more information, send your question to dewaivers@cms.hhs.gov.
