This report outlines the history and purpose of Medicaid waivers, describes California's Medi-Cal waiver programs, outlines the waiver approval processes, and discusses additional waiver opportunities for California.
Medicaid Waivers: California's Use of a Federal Option (261 K)
Guidelines for Medi-Cal (California's Medicaid program) are based on laws and regulations created by the federal government. It is no small task for an individual state to modify its Medicaid program.
Specifically, when a state wants to make significant changes to its Medicaid program, it must take one of two steps: either (1) amend its State Medicaid Plan (the contract with the federal government); or (2) receive an exemption or “Medicaid waiver” from portions of Title XIX of the Social Security Act by the U.S. Department of Health and Human services.
Over 40 states, including California, have received waivers to adapt their Medicaid programs in a variety of ways. At the time of this report, California had 29 active Medicaid waivers and more than half of the state’s Medi-Cal recipients received services in a delivery system created under a waiver. Examples of modifications made to the Medi-Cal program that required waivers include: redirecting indigent care funds; expanding Medi-Cal eligibility; restructuring models of care delivery; changing the Medi-Cal benefits package; and simplifying the Medi-Cal program.
This report includes:
The full report can be found under Document Downloads below.