AEGiS-APPJ: The Adequacy of Reimbursement for HIV under Section 1115 Medicaid Waivers

Important note: Information in this article was accurate in 1997. The state of the art may have changed since the publication date.

The Adequacy of Reimbursement for HIV under Section 1115 Medicaid Waivers

AIDS & Public Policy Journal 12, no. 3 (Fall 1997): 112-27
R. Conviser, D. Kerrigan, and S. Thompson

Since 1993, there has been an explosive growth in the adoption of managed care by state Medicaid programs. By early 1993, just two states--Arizona and Oregon--had been granted the necessary waivers under Section 1115 of the Social Security Act to institute statewide Medicaid managed-care programs. Such waivers are required to exempt managed-care programs from certain federal regulations that govern fee-for-service Medicaid, such as eligibility requirements, benefits offered, or choice of healthcare providers. . . . Under the Balanced Budget Agreement passed by the U.S. Congress in 1997, states will be able to institute Medicaid managed-care programs without obtaining waivers through an option offered to the states. However, such programs will be subject to quality assessment and performance improvement initiatives as specified in Section 1932c of the Social Security Act, as well as other regulations that the Health Care Financing Administration (HCFA) is preparing.
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APPJ970302

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