Latest
CMS Approves California Advancing & Innovating Medi-Cal (CalAIM) Waivers, Including Provisions to Address Social Determinants of Health
In December, CMS approved some of California’s CalAim proposals through extensions of its 1115 demonstration and 1915(b) managed care waivers....
CMS Rescinds 10-year Extension of Texas 1115 Waiver
On April 16, 2021, CMS rescinded its approval of Texas’ 1115 waiver, citing insufficient justification for granting an emergency exemption to the...
CMS Rescinds 1115 Letters of Agreement Sent to States
On Feb. 12, 2021, CMS rescinded the Letters of Agreements sent to states January 4, declaring that the procedures outlined in the Special Terms and...
Waivers
DSRIPS and Related Programs
At Eyman Associates, we monitor developments in the use of 1115 waiver demonstrations to support delivery system transformation on an ongoing basis and strive to provide the most current and thorough information possible for our clients.
California
Current Program: Public Hospital Redesign and Incentives in Medi-cal (PRIME)
- Medi-Cal 2020 Approval Documents
- Department of Health Care Services: Concepts for California’s Next Waiver Renewal, July 2014
- California DSRIP website (contains each participating hospital’s DSRIP plan and annual and semi-annual reports)
Previous Program: Delivery System Reform Incentive Payments (DSRIP)
- California Bridge to Reform Waiver Resources
Kansas
Massachusetts
Current: Delivery System Reform Incentive Payment (DSRIP) Program
- MassHealth Waiver Approval Documents
Previous Program: Delivery System Transformation Initiatives (DSTI) Program
- MassHealth Waiver Approval Documents through November 3, 2016
- MassHealth Waiver Approval Documents through October 29, 2014
- Eyman Associates Policy Watch: What You Need to Know About the Massachusetts Waiver Renewal
New Jersey
New Mexico
Hospital Quality Improvement Incentive Pool
- New Mexico Centennial Care Approval Documents (includes the Hospital Quality Improvement Incentive Pool)
New York
Oregon
Texas
Delivery System Reform Incentive Payments (DSRIP)
- Texas Healthcare Transformation and Quality Improvement Program Documents
- Key links to Texas Health and Human Services Commission Website
- Overview Information and Resources
- Tools and Guidelines for Regional Healthcare Partnership Participants
- DSRIP Project Summaries
DSRIP Timeline

Uncompensated Care Pools
A number of states have received approval under section 1115 demonstration authority for funding pools that provide support for uncompensated costs incurred by providers. Eyman Associates continues to track these programs closely. The resource below provides CMS approval documents for all current and expired uncompensated care (UC) pools and related programs, including independent evaluation reports required by CMS.
Arizona
California
- Global Payment Program Waiver Documents
- Independent Report: Evaluation of Uncompensated Care Financing for California Designated Public Hospitals, Navigant, May 2016
Florida
- Low Income Pool Waiver Documents
- Independent Report: Study of Hospital Funding and Payment Methodologies for Florida Medicaid, Navigant, February 2015
Hawaii
- UC Pool Waiver Documents
- Expired June 2016
Kansas
- UC Pool Waiver Documents
- Independent Report: Evaluation of Uncompensated Care Pool and Delivery System Reform Incentive Payment Program Funding for Kansas Medicaid 1115 Waiver, Navigant, September 2017
Massachusetts
- SNCP Waiver Documents
- Independent Report: Evaluation of Safety Net Care Pool Financing Report, Navigant, February 2016
New Mexico
- SNCP Waiver Documents
- Independent Report: Analysis of Current Uncompensated Care Pools, Myers and Stauffer, November 2017
Tennessee
- UC Pool Waiver Documents
- Independent Report: PCG Review of Medicaid and Uncompensated Care Costs and Supplemental Payment Methodologies in TennCare, PCG, March 2016
Texas
- UC Pool Waiver Documents
- Independent Report: Evaluation of Uncompensated Care and Medicaid Payments in Texas Hospitals and the Role of Texas’ Uncompensated Care Pool, HMA, August 2016