In the midst of the national push for Medicaid reform, one albatross is
often cited by state policymakers for impeding their progress: the
federal waiver process. The long and short of it is that it takes too long to get a waiver approved by the Centers for Medicare and Medicaid Services (CMS) if a state has an innovative idea to test. There are
horror stories about waivers taking more than a year to be approved,
even if they’ve been approved in the past and states are just looking to
continue their programs. Six former governors (three Democrats and
three Republicans) issued a report
last year, bemoaning the problems with the waiver process and offering
their recommendations for fixing it. CMS officials have acknowledged
that it could be streamlined, though no specific improvements have been
named or acted upon.
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