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December 29, 2020

CMS Approves 1-Year Extension of CA 1115 Waiver Demonstration

On December 29, 2020, the Centers for Medicare & Medicaid Services (CMS) approved California’s request to extend its 1115 waiver demonstration, “Medi-Cal 2020,” for one year. Medi-Cal 2020 was approved for a five-year period on December 30, 2015, building off California’s previous 5-year “Bridge to Reform” waiver and was set to expire on December 30, 2020. The approval comes amid the State’s efforts to negotiate a longer-term extension of its waiver and implement its multi-year initiative, California Advancing and Innovating Medi-Cal (CalAIM). Notably, California’s request did not include an extension of its delivery system reform incentive payment (DSRIP) program, as the State is instead completing its transition of that program into a Medicaid managed care directed payment, renamed the Quality Incentive Program (QIP). In its extension approval, CMS also clarified that California will not earn buget neutrality savings during this temporary extension, reflecting CMS’ revised budget neutrality policy outlined in its 2018 State Medicaid Director’s Letter.