Reforming Medicaid Waivers: The Governors' Council Perspective on Federalism Today

This Bipartisan Policy Center report contains a five-point plan for improving the process used by the Centers for Medicare & Medicaid Services to review state Medicaid waiver requests. Recommendations include:

• CMS should develop general templates that states can use to apply for waivers, thereby streamlining and simplifying the process.
• CMS should develop more targeted templates that states can use to apply for waivers to implement best practices that have already been identified in state plan amendments submitted by other states.
• CMS should improve transparency by ensuring that all relevant parties, including the Office of Management and Budget, are engaged at the beginning of the waiver process.
• CMS should establish a mechanism for converting successful waivers into permanent or semipermanent state Medicaid innovations.
• The advice and guidance provided to states by new Medicaid State Technical Assistance Teams, established within the Department of Health and Human Services by PPACA, should be widely disseminated so that other states dealing with the same issues have the benefit of that advice and guidance.