The CMS on Tuesday approved a Medicaid Section 1115 emergency waiver for Washington state, making it the first state to get approval.
Under the waiver, Washington will be able to target Medicaid services to areas hit hard by COVID-19 rather than deliver services evenly across the state. The state can also differentiate and target specific populations affected by the virus and "triage access to long-term services and supports based on highest need," the CMS wrote in its approval letter.
"CMS has determined that the Washington (waiver) is necessary to assist the state in delivering the most effective care to its beneficiaries in light of the COVID-19 (public health emergency)," the agency said.
The state can now pay retainers for personal care and rehabilitation providers, including occupational and physical therapists, to make sure those services are available during the outbreak. Many providers have seen a massive decline in revenue since the pandemic began and retainer payments can help them stay in business. Washington can also loosen and expedite eligibility for long-term care services and supports, among other changes.
But the agency declined to approve several of the state's requests to expand coverage and other help.
"CMS will not be approving Washington's request to establish a temporary eligibility group for individuals with incomes at or below 200 percent (of the federal poverty line) and for whom the state would subsidize the cost of new or existing Qualified Health Plan coverage in the marketplace," the agency said.
It also denied Washington's request to use Medicaid money to create a disaster relief fund "to cover costs associated with treatment for uninsured individuals with COVID-19, housing, nutrition supports and other COVID related expenditures." The agency believes that other resources are now available through the relief packages passed by Congress.
And the CMS didn't approve the state's requests to extend retainer payments beyond 30 days or to allow so-called "transportation brokers" to provide non-emergency medical transportation.
"A Medicaid transportation broker contracts with (a state Medicaid agency) to manage preauthorized NEMT services in a designated area," according to a CMS booklet for providers.
The CMS last month invited states to apply for emergency Medicaid demonstration waivers to help them prevent or address shortages of healthcare supplies and services caused by the coronavirus pandemic. All approved waivers will expire when the public health emergency ends.