United States Government Publishing Office publisher pbl distributor dst United States Government Accountability Office Health, Education, and Human Services Division author aut Government Organization text government publication eng GAOREPORTS Legislative Agency Publications gao legislative 2010-08-12 U.S. Government Printing Office 1995-11-08 monographic deposited born digital 91 p. GA 1.13:HEHS-96-44 https://www.govinfo.gov/app/details/GAOREPORTS-HEHS-96-44 P0b002ee180382a4a f:he96044 DGPO 2010-08-12 2011-03-23 GAOREPORTS-HEHS-96-44 machine generated eng fdlp REPORT GAOREPORTS-HEHS-96-44 HEHS-96-44 Medicaid programs Health maintenance organizations State-administered programs Waivers Health care cost control Federal/state relations Medical economic analysis Financial management Health resources utilization Tennessee Florida Oregon Hawaii Minnesota Illinois New York Kentucky Medicaid Disproportionate Share Hospital Program Texas Oklahoma Arizona MinnesotaCare Program Medicaid Medically Needy Program Rhode Island Ohio Chapter Report HEHS

Pursuant to a congressional request, GAO examined the financing arrangements for four approved section 1115 Medicaid demonstration waivers.<p/>GAO found that: (1) the approved spending limits for demonstration waivers in Oregon, Hawaii, and Florida are not budget neutral and could increase federal Medicaid expenditures; (2) Tennessee's 1115 waiver agreement should cost less than the continuation of its prewaiver program and result in savings; (3) although additional federal funding is relatively lower than demonstration spending under federal expenditure caps, federal Medicaid expenditures could increase rapidly if similar flexibility in reviewing state 1115 financing strategies is allowed; (4) five waivers have been approved since late 1994, and the backlog of pending waivers includes three states with large Medicaid programs; (5) additional federal funding is available to protect against the uncertainties states face in implementing demonstrations; and (6) it remains unclear whether the states implementing demonstrations will exceed their 1115 waiver funding caps. https://www.govinfo.gov/content/pkg/GAOREPORTS-HEHS-96-44/html/GAOREPORTS-HEHS-96-44.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-HEHS-96-44/pdf/GAOREPORTS-HEHS-96-44.pdf GAO/HEHS-96-44 https://www.govinfo.gov/app/details/GAOREPORTS-HEHS-96-44 Chapter Report GAO/HEHS-96-44; Medicaid Section 1115 Waivers: Flexible Approach to Approving Demonstrations Could Increase Federal Costs; Medicaid programs Health maintenance organizations State-administered programs Waivers Health care cost control Federal/state relations Medical economic analysis Financial management Health resources utilization Tennessee Florida Oregon Hawaii Minnesota Illinois New York Kentucky Medicaid Disproportionate Share Hospital Program Texas Oklahoma Arizona MinnesotaCare Program Medicaid Medically Needy Program Rhode Island Ohio Title 29 Section 1001et seq. 29 U.S.C. 1001et seq. Title 42 Section 1396b(m) Title 42 Section 1396(b)(r)(2) 42 U.S.C. 1396b(m) 42 U.S.C. 1396(b)(r)(2) Volume 88 Page 829 88 Stat. 829 Public Law 93-406