National Health Policy Forum

The Basics

Date: AUGUST 26, 2009
Title:
Medicaid Waivers and Budget Neutrality PDF Doc.
Author: Cynthia Shirk, Consultant
Summary: All states operate one or more Medicaid waiver programs. In order to gain approval from CMS for waiver programs, states must first show that the activities under the waiver will be “budget neutral,” meaning federal Medicaid expenditures over the waiver approval period must be no greater than they would have been without the waiver. This publication explains the concept of budget neutrality in the context of Medicaid waivers and how it is calculated.
Related
Materials:
See also, "Medicaid and SCHIP Waivers" (The Basics, July 30, 2008) and "Shaping Medicaid and SCHIP Through Waivers: The Fundamentals" (Background Paper No. 64, July 22, 2008).