DEPARTMENT OF HEALTH AND HUMAN SERVICES 
Centers for Medicare & Medicaid Services 
7500 Security Boulevard, Mail Stop S2-26-12 
Baltimore, MD 21244-1850 
 
Center for Medicaid and CHIP Services 
 
CMCS Informational Bulletin 
  
 
DATE:  February 22, 2012 
 
FROM:  Cindy Mann, Director 
  Center for Medicaid and CHIP Services (CMCS) 
 
SUBJECT:  Review and Approval Process for Medicaid and CHIP Section 1115 
Demonstrations  Final Rule and Other New Assistance to States   
 
Today the Centers for Medicare & Medicaid Services (CMS) put on display at the Federal 
Register a final rule that establishes a process to promote State and Federal transparency for 
Medicaid and Childrens Health Insurance Program (CHIP) demonstrations. The rule is designed 
to ensure public input in the development, review, and approval (or extension) of Medicaid and 
CHIP demonstration projects under section 1115 of the Social Security Act.   
 
This final regulation codifies the provisions of section 10201(i) of the Affordable Care Act of 
2010, and is available for viewing today at 
http://www.ofr.gov/(X(1)S(vptsjs314z120avnlzsgtvpg))/OFRUpload/OFRData/2012-
04354_PI.pdf   After today, it will be posted at http://www.access.gpo.gov listed under the 
publication date of February 22, 2012, or you can access it at http://medicaid.gov/Federal-Policy-
Guidance/Federal-Policy-Guidance.html.  A fact sheet on the rule is available at: 
http://www.cms.gov/apps/media/press/factsheet.asp?Counter=4284. 
 
This final rule is effective on April 27, 2012. To facilitate the implementation of the rule, we are 
modifying our section 1115 demonstration  information on www.Medicaid.gov and developing a 
demonstration application template that States can use to submit to CMS.   
   
We will extend a forthcoming invitation to State Medicaid and CHIP agencies to participate in 
an all-State call on Tuesday, February 28, 2012, from 3-4pm ET, to provide a more detailed 
overview of the final rule related to section 1115 demonstration and answer questions. We look 
forward to working closely with States and other stakeholders to ensure that the Medicaid and 
CHIP section 1115 demonstration review process is transparent and completed in a timely 
manner.  Please contact Jessica Schubel with any questions at Jessica.Schubel@cms.hhs.gov.  
 
For more information about approved and pending section 1115 demonstrations, please see:  
http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/Section-
1115-Demonstration.html  
  CMCS Informational Bulletin  Page 2 
In addition, today the Departments of Health and Human Services (HHS) and Treasury finalized 
regulations outlining the steps States may pursue in order to receive a State Innovation Waiver 
under the Affordable Care Act, providing States with the flexibility to innovate and implement 
the health care solutions through the Exchanges, beginning in January 2017. The final rule, 
available at 
http://www.ofr.gov/(X(1)S(04oh2m0j2iptxgb30tfl0wol))/OFRUpload/OFRData/2012-
04395_PI.pdf describes the process for filing a State Innovation waiver application, along with 
the content of the application and the process for the public to review and comment on proposed 
waivers.  More information on the State Innovation Waivers is available at: 
http://www.cms.gov/apps/media/press/factsheet.asp?Counter=4282  
 
Finally, today HHS announced the award of $229 million in Affordable Insurance Exchange 
grants to 10 States to help them create Exchanges, giving these states more flexibility and 
resources to implement the Affordable Care Act.  Todays awards bring to 33 the number of 
States that are making significant progress in creating Affordable Insurance Exchanges. More 
information on Exchange Grants is available at:  
http://www.healthcare.gov/news/factsheets/2011/05/exchanges05232011a.html  
 
To view the press release for todays announcements please visit: 
http://www.cms.gov/apps/media/press/release.asp?Counter=4283