1115 Demonstration Waiver

1115 Demonstration Waiver Amendment

Building and Transforming Coverage, Services, and Supports for a Healthier Virginia

The Department of Medical Assistance Services (DMAS) is planning to submit an amendment to Virginia’s “Building and Transforming Coverage, Services, and Supports for a Healthier Virginia” 1115 Demonstration waiver to the Centers for Medicare and Medicaid Services in December 2024. 

Serious Mental Illness (SMI) Demonstration Waiver Amendment

Pursuant to 42 CFR §431.408, notice is hereby given that the Virginia Department of Medical Assistance Services (DMAS) is seeking to amend its Medicaid Section 1115 Demonstration entitled “Building and Transforming Coverage, Services, and Supports for a Healthier Virginia.” (No. 11-W-0029713)  

DMAS is providing an opportunity for the public to review and provide input on the Demonstration amendment application November 8, 2024 through December 11, 2024.

The current demonstration is scheduled to expire on December 31, 2024 and a renewal application to extend the current demonstration for five years was submitted to CMS on August 2, 2024.  The current 1115 Demonstration waiver as well as the renewal application submitted to CMS includes two programs.  The two current components of the 1115 demonstration waiver are the substance use disorder (SUD) institutes of mental disease (IMD) and Former Foster Care Youth (FFCY) programs.  

With this amendment application, Virginia seeks waiver authority for serious mental illness (SMI) IMD coverage in response to an opportunity announced to states via a State Medicaid Director letter in 2018. 

DMAS will conduct a public notice process that will include posting a notice on this page (please see below) and on the Virginia Regulatory Town Hall. DMAS will also send the notice out to an electronic list of over 200,000 providers, members and stakeholders.

Starting on November 8, 2024, public input may be submitted via the Town Hall public comment forum at https://townhall.virginia.gov/L/Forums.cfm (scroll down to Department of Medical Assistance Services and click on “View or Enter Comments”) or to Lisa Jobe-Shields, Behavioral Health Division Director, by phone (804-814-9216), email: (lisa.jobe-shields@dmas.virginia.gov), or by mail:

Lisa Jobe-Shields, DMAS, Behavioral Health Division, 600 E. Broad Street, Richmond, VA 23219.

Comments must be received no later than 11:59 pm (Eastern Time) on December 11, 2024.

DMAS will hold two public hearings at the times and locations below, where verbal or written public comments can be submitted.  All verbal public comments should be limited to two minutes each.

To participate in the public meetings, please use the information provided below:

After considering public comments about the proposed demonstration amendment application, DMAS will make final decisions about the demonstration and submit a revised application to CMS.

Additional information about this demonstration is also available on the CMS website at https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/index.html

The Department of Medical Assistance Services (DMAS) is planning to submit the 1115 waiver renewal application for the “Building and Transforming Coverage, Services, and Supports for a Healthier Virginia” 1115 Demonstration to the Centers for Medicare and Medicaid Services in July 2024.  The current waiver is set to expire on December 31, 2024.

ARTS and Former Foster Care 1115 Demonstration Renewal

Pursuant to 42 CFR § 431.408, DMAS is providing a notice of intent to submit to the federal Centers for Medicare and Medicaid Services (CMS) a request to renew its Section 1115 Demonstration called “Building and Transforming Coverage, Services, and Supports for a Healthier Virginia.”

DMAS is providing an opportunity for members of the public to review and provide input on the waiver renewal application. The public comment period will take place from May 30 through June 29, 2024.

The 1115 demonstration includes two parts:

• • Coverage for residential Addiction and Recovery Treatment Services (ARTS); and
  • Coverage for former foster care youth under age 26 who were in foster care under the responsibility of another state on the date they turned 18 years of age, and who turned 18 prior to January 1, 2023.

A third part of the demonstration relating to “High Needs Supports” is being removed, as that part of the waiver has not received General Assembly funding since it was approved by CMS in 2020.

DMAS will conduct a public notice process that will include posting a notice on this page (please see below) and on the Virginia Regulatory Town Hall. DMAS will also send the notice out to an electronic list of over 200,000 providers, members and stakeholders.

Starting on May 30, 2024, public input may be submitted via the Town Hall public comment forum at https://townhall.virginia.gov/L/Forums.cfm (scroll down to Department of Medical Assistance Services and click on “View or Enter Comments”) or to Jason Lowe, Behavioral Health Integration Advisor, by phone (804-659-8732), email (Jason.Lowe@dmas.virginia.gov), or mail (Jason Lowe, DMAS, Behavioral Health Division, 600 E. Broad Street, Richmond, VA 23219.) Comments must be received no later than 11:59 pm (Eastern Time) on June 29, 2024.

DMAS will hold two public hearings at the times and locations below, where verbal or written public comments can be submitted. All verbal public comments should be limited to two minutes each.

To participate in the public meetings, please use the information provided below:

After considering public comments about the proposed demonstration renewal application, DMAS will make final decisions about the demonstration and submit a revised application to CMS.

Additional information about this demonstration is also available on the CMS website at https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/index.html