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 Renewal Application (2021) - Updated June 30, 2021

The Maryland Department of Health (the Department) has proposed to renew its §1115 demonstration waiver known as HealthChoice and submitted this application to the Centers for Medicare and Medicaid Services (CMS) on June 30, 2021. To review the Department's finalized §1115 demonstration waiver application that has been submitted to CMS, please review the resources below .

§1115 Waiver Renewal Resources (2021)

The Department accepted public comments from May 4, 2021, through June 4, 2021 and received comments from interested stakeholders, which may be found in Appendix B of the waiver application.

This year's public hearings were held via webinar to discuss the content of the waiver amendment and solicit feedback and input from public stakeholders on May 11, 2021 and May 27, 2021. Meeting information from both of the public hearings may be found below. The 2021 Post-Award Forum was held jointly with the second §1115 demonstration waiver renewal hearing on May 27, 2021 at 3:00 pm, via webinar. Meeting materials from the Post-Award Forum, which are the same as the materials from the first public hearing,  may be found at the HealthChoice Post-Award Forum website.


Archival Information 

§1115 Waiver Renewal Application (2021) - Updated May 4, 2021

The Maryland Department of Health (the Department) is proposing to renew its §1115 demonstration waiver known as HealthChoice.The Department intends to seek authorization to continue current pilots and programs permitted under the current §1115 waiver, as well to modify the Assistance in Community Integration Services Pilot, the Home Visiting Services Pilot, and the Residential Treatment for Substance Use Disorder program. In addition, the Department is seeking authorization for new programs, including the Expansion of IMD Services for Adults with Serious Mental Illness, the Maternal Opioid Misuse (MOM) Model, and the Emergency Triage, Treat and Transport (ET3) Model.

In FY 2020, there were 1,620,533 individuals enrolled in the Medicaid program, including 1,370,465 individuals in HealthChoice. This demonstration is not expected to increase or decrease annual enrollment. 

Per the terms of the §1115 HealthChoice demonstration renewal as required by 42 CFR 431.420(c), the Department must conduct a post-award forum within six months of implementing the demonstration and annually thereafter. The forum is intended to provide the public with the opportunity to offer meaningful comments on the progress of the demonstration.

As of May 4, 2021, the State’s 30-day public comment period is open. The Department will accept comments through June 4, 2021.  To review the Department’s draft §1115 demonstration waiver application, please click here​.

§1115 Waiver Renewal Resources (2021)


Hard copies of the application may be obtained by calling (410) 767-5208.  Interested parties may send written comments concerning the waiver amendment to Tricia Roddy, Deputy Medicaid Director, Office of Healthcare Financing, 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 4, 2021, through June 4, 2021. 


The following public hearings will discuss the content of the waiver amendment and solicit feedback and input from public stakeholders. The 2021 post-award forum will be held jointly with the second §1115 demonstration waiver renewal hearing on May 27, 2021 at 3:00 pm, via webinar. The webinar registration and call-in information are found below. Meeting materials will be posted on the following website as the meeting date approaches:
https://mmcp.health.maryland.gov/healthchoice/Pages/HealthChoice-Post-Award-Forum.aspx.

Virtual Webinar and Audio Conference #1: §1115 Waiver Demonstration Renewal Application 

Tuesday, May 11, 2021; 10:00 AM – 12:00 PM

Maryland Department of Health 

GoToWebinar Virtual Platform

To participate in the public hearing via webinar, please register via:  https://attendee.gotowebinar.com/register/2810866705598972683

Please note that if you desire to make a public comment, you will need to register via the link above.  After registering, you will receive a confirmation email containing audio and visual information about joining the webinar.
Call-in number:  (415) 655-0060
Access code:   610-004-077
The call-in number and access code presented above is for attendees who wish to join in listen-only mode.

Virtual Webinar and Audio Conference #2: §1115 Waiver Demonstration Renewal Application and HealthChoice Post Award Forum
Thursday, May 27, 2021; 3:00 PM – 5:00 PM
Maryland Department of Health
GoToWebinar Virtual Platform
To participate in the public hearing via webinar, please register via:  https://attendee.gotowebinar.com/register/4831209426033221900
Please note that if you desire to make a public comment, you will need to register via the link above.  After registering, you will receive a confirmation email containing audio and visual information about joining the webinar.
Call-in number: 1 (562) 247-8321
Access code:   415-369-968
The call-in number and access code presented above is for attendees who wish to join in listen-only mode.


§1115 Waiver Amendment (2020) - Updated May 5, 2020

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 approved §1115 HealthChoice Demonstration Waiver Amendment and Special Terms & Conditions (approved April 16, 2020) are 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. 


§1115 Waiver Amendment (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. 


§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
Annapolis Public Stakeholder Meeting - June 6, 2018
§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.