CMS approves Oregon’s waiver request for Medicaid flexibility during COVID-19 pandemic

The Centers for Medicare & Medicaid Services (CMS) on Wednesday approved Oregon’s 1135 waiver request, granting the state more flexibility in how it utilizes Medicaid services and funding to combat the COVID-19 pandemic.

President Trump’s national emergency declaration on March 13 enabled CMS to waive certain requirements for Medicaid, Medicare, and CHIP under Section 1135 emergency authority. Following the declaration, several states quickly submitted waiver requests to ease federal rules and remove barriers as they race to diagnose and treat COVID-19 patients. The Oregon Health Authority (OHA) submitted its waiver request on March 20.

 

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CMS’s approval letter to Oregon Medicaid Director Lori Coyner details the specific changes now allowed through the waiver. Along with the blanket waivers issued by CMS, OHA has been approved to temporarily suspend Medicaid fee-for-service prior authorization requirements, extend pre-existing authorizations, and suspend pre-admission screenings and Annual Resident Review (PASRR) Level I and Level II Assessments for 30 days.

During the public health emergency, the waiver also authorizes Oregon to temporarily enroll providers that are enrolled with other State Medicaid Agencies, and outlines criteria to reimburse out-of-state providers.

The approved waiver also allows facilities that don’t normally provide Medicaid services to be fully reimbursed for services provided during the public health emergency, provided they meet minimum standards. These types of facilities may include nursing facilities, psychiatric residential treatment facilities, or intermediate care facilities for individuals with intellectual and developmental disabilities.

CMS says they are continuing to work on the additional waiver requests from Oregon that are not included in the approval letter.

The majority of the approved 1135 waivers are effective March 1, 2020, and will expire at the end of the public health emergency.