Getting new drugs on a formulary may be difficult. Section 1115 Waiver - is a provision permitting operation outside of normal compliance that is named for the section of the law that authorizes demonstration exceptions. Section 1115 has usually required rigorous research and evaluation designs, time limits, and no greater cost in ffp than otherwise would have been incurred. It was created as an alternative to institutional care. Persons who would otherwise need institutional care may choose between that and community-based care.
Normal operation allows recipients full choice of participating providers.
However, the stable funding requirement for a capitated system like an HMO precludes the option of choosing another system within the contract year. Such networks must include hospital, pharmacy, laboratory, and treatment professionals. The network is then at risk for additional costs if necessary to deliver appropriate services to all enrollees. The study can be obtained from Morris Area Lyme Support, P.O.Box 1483, Morristown, NJ 07960. The course is taught by trained family members.