HLB Advisories: CMS Grants Rhode Island 1135 Waiver Request
March 26, 2020
On March 24, 2020, CMS responded to the state of Rhode Island’s request for waivers regarding a number of federal Medicaid requirements that pose issues or challenges for the state in the face of the COVID-19 public health emergency. In its approval letter, CMS agreed to:
- Temporarily suspend Medicaid fee-for-service prior authorization requirements;
- Extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency;
- Extend deadlines for state fair hearing requests and timelines for appeals;
- Relax requirements for reimbursement of claims from out-of-state providers not enrolled in Rhode Island Medicaid; and
- Waive certain provider enrollment requirements to allow for temporary, provisional enrollment of new providers, including out-of-state providers.
These waivers automatically terminate upon termination of the public health emergency.
For additional detail, please see CMS’ approval letter. To date, CMS has also granted waivers to 21 states in addition to Rhode Island (Alabama, Arizona, California, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, New Hampshire, New Jersey, New Mexico, North Carolina, North Dakota, Oklahoma, Oregon, South Dakota, Virginia, and Washington). Copies of these waivers can be found here. Additional COVID-19 resources can be found on Hooper, Lundy & Bookman, PC’s COVID-19 Resource Page.