DHCS Submits CalAIM Waiver Applications to CMS

On Wednesday, the California Department of Health Care Services (DHCS) submitted the California Advancing and Innovating Medi-Cal (CalAIM) Section 1115 Demonstration and CalAIM Section 1915(b) Waiver to the U.S. Centers for Medicare & Medicaid Services (CMS) for review and approval.

By submitting the applications, DHCS is seeking federal approval to implement key components of the CalAIM Initiative, which seeks to establish broad, multiyear system, program, and payment reforms to deliver population health, person-centered approaches to improving health outcomes among Medi-Cal beneficiaries and other low-income populations in California.

The CalAIM Section 1115 Demonstration Application seeks to amend and renew the existing Medi-Cal 2020 Section 1115 Demonstration, approved through December 31, 2021. DHCS is requesting approval by December 2021 to enable implementation beginning in January 2022. A 30-day public comment period will be held by the federal government on DHCS’ demonstration application. The comment period is anticipated to begin this month and more information will be made available when the comment period begins.

The CalAIM Section 1915(b) Waiver Application seeks to amend and renew the existing Specialty Mental Health Services (SMHS) Section 1915(b) Waiver and consolidate Medi-Cal managed care, dental managed care, SMHS, and the Drug Medi-Cal Organized Delivery System (DMC-ODS) under a single 1915(b) waiver. The existing SMHS Section 1915(b) will expire on December 31, 2021. DHCS is requesting approval by December 2021 to enable implementation in January 2022. There is no federal public comment period for the CalAIM Section 1915(b) Waiver.

Additional information on the applications, as well as the submitted materials, is available here.