Coronavirus waivers & flexibilities
In certain circumstances, the Secretary of the Department of Health and Human Services (HHS) using section 1135 of the Social Security Act (SSA) can temporarily modify or waive certain Medicare, Medicaid, CHIP, or HIPAA requirements, called 1135 waivers. There are different kinds of 1135 waivers, including Medicare blanket waivers. When there's an emergency, sections 1135 or 1812(f) of the SSA allow us to issue blanket waivers to help beneficiaries access care. When a blanket waiver is issued, providers don't have to apply for an individual 1135 waiver. When there's an emergency, we can also offer health care providers other flexibilities to make sure Americans continue to have access to the health care they need.
Waivers & flexibilities for health care providers
- Get a quick-start guide to learn how to submit an 1135 General waiver (PDF), an 1135 Medicaid waiver (PDF), or a PHE inquiry (PDF)
- Watch our YouTube training videos:
- Report technical issues by email (Note “Waiver/Flexibility" in the subject line)
Learn how we're easing burden and helping providers care for Americans by offering new waivers and flexibilities:
- Waiver for Medicare Ground Ambulance Services Treatment in Place (PDF) (5/5/21)
- COVID-19 Emergency Declaration Blanket Waivers & Flexibilities for Health Care Providers (PDF) UPDATED (5/24/21)
- Blanket waivers of Section 1877(g) of the Social Security Act (3/30/20)
- Medicare and Medicaid IFC: Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency (CMS-9912 IFC) (PDF) (10/28/20)
- Medicare and Medicaid IFC: Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency (CMS-3401 IFC) (PDF) (8/25/20)
- Interim Final Rule (IFC), CMS-3401-IFC, Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency related to Long-Term Care (LTC) Facility Testing Requirements and Revised COVID-19 Focused Survey Tool (8/26/20)
- Interim Final Rule (IFC), CMS-3401-IFC, Updating Requirements for Reporting of SARS-CoV-2 Test Results by (CLIA) of 1988 Laboratories, and Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency (8/26/20)
- Medicare and Medicaid IFC: Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency (CMS-5531 IFC) (PDF) (4/30/20)
- Acute Hospital Care At Home waiver request (11/25/20)
- List of Hospital Outpatient Services and List of Partial Hospitalization Program Services Accompanying the 4/30/2020 IFC (ZIP) (4/30/20)
- Innovation Model COVID-19 Adjustments (PDF) (6/3/20)
- List of lab test codes for COVID-19, Influenza, RSV (PDF) (5/12/20)
- Medicare IFC: Revisions in Response to the COVID-19 Public Health Emergency (CMS-1744-IFC) (PDF) (3/30/20)
- IFC Federal Register Announcement (4/1/20)
- COVID-19 Regulations & Waivers To Enable Health System Expansion (PDF) UPDATED (1/19/21)
- Graphic Overview of Flexibilities (PDF) (3/30/20)
- Frequently Asked Questions to Assist Medicare Providers (PDF) UPDATED (3/5/21)
- Provider Burden Relief Frequently Asked Questions (PDF) UPDATED (7/7/20)
- Provider Enrollment Relief Frequently Asked Questions (PDF) (3/30/20)
- Updates for State Surveyors and Accrediting Organizations (EMTALA and Infection Control) (3/30/20)
- Reprioritization of PACE, Medicare Parts C and D Program, and Risk Adjustment Data Validation (RADV) Audit Activities (HPMS Memo) (3/30/20)
- Rural Providers (PDF) (8/20/20)
1135 blanket waivers
What do I need to know about 1135 blanket waivers?
If you're an entity in the declared emergency area, you can apply for an 1135 waiver. You'll usually hear back from us within 2-3 days, but if your request is more complicated, it may take up to a week. If your waiver request has 1 or 2 items, we may get back to you within 24 hours.
Once approved, waivers have a retroactive effective date of March 1, 2020 and will end no later than when the emergency declaration's ended.
Waivers don't offer grants or financial assistance. They also don't allow you to be paid for services that aren't usually covered or for people to be eligible for Medicare who aren't otherwise eligible. You also shouldn't base your response decisions, like evacuations, on waivers. Once your waiver's approved, as always to be reimbursed accurately, be sure to keep careful records about the services you provide and the beneficiaries you provide them to.
Other 1135 waivers & 1915(c) waivers
Approved states' other Coronavirus 1135 waivers
Approved states' Coronavirus Home & Community Based (HCBS) 1915(c) Appendix K waivers
Approved states’ 1115 demonstrations
Medicaid State Plan amendments
CHIP State Plan amendments
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