Key Points
- Section 1115 of the Social Security Act gives the Secretary of Health and Human Services authority to approve experimental, pilot, or demonstration projects that promote the objectives of the Medicaid and CHIP programs.
- Under this authority, the Secretary may waive certain provisions of the Medicaid law or allow states to use federal Medicaid and CHIP funds for costs not otherwise matchable to give states additional flexibility to design and improve their programs.
FIM Opportunities
Section 1115 demonstrations allow states to test new approaches in Medicaid service delivery, including nutrition-related and other supportive services, which CMS reviews on a case-by-case basis consistent with federal Medicaid requirements.
Nutrition supports are provided through a variety of Medicaid authorities and the Money Follows the Person program for specific populations. States may use section 1115 demonstrations to expand the eligible population to additional groups for these nutrition supports.
Demonstrations also include evaluation requirements to assess utilization, quality, and outcomes. Testing and evaluating innovative programs through section 1115 demonstrations allows CMS and states to ultimately scale proven programs that improve beneficiary health for the long term.
All section 1115 demonstrations are subject to budget neutrality requirements.
