States will be able to continue their 1915(c) Appendix K waivers for home- and community-based services past their initial expiration date, the Centers for Medicare & Medicaid Services said in a recent letter to state Medicaid directors.
These waivers were initially set to expire on Nov. 11, but CMS does not anticipate it will be possible to review all Appendix K actions by this deadline.
“The ability for these waiver actions to be submitted, reviewed and approved by November 11, 2023, to prevent a lapse in authority, is highly uncertain,” Daniel Tsai, deputy administrator and director of the Center for Medicaid and CHIP Services, said. “In the name of minimizing disruption to beneficiaries, providers and states, CMS is issuing this extension of the Appendix K expiration date.”
Though Appendix K waivers will not require any amendments to take advantage of the extended deadline, states must apply to incorporate them into existing HCBS waivers to maintain provisions activated by Appendix K waivers.
“If a state has not submitted a waiver action or demonstration amendment to incorporate Appendix K flexibilities into an underlying program by November 11, 2023, the Appendix K flexibility will expire for that program on that date,” Tsai said.
Appendix K waivers were used extensively during the COVID-19 pandemic due to their flexibility in authorizing telehealth services, provider network expansions, payment rate increases, self-directed health services and other measures. Providers, such as home care agencies, relied on the waivers to deliver care during the public health emergency.
For example, In Ohio, Appendix K was utilized to deploy telehealth services and to allow healthcare services to be provided at alternative locations besides clinics, such as in the home.
