Waiver Development

Insights From Our Experts


We provide strategic consultation and support to states seeking federal waivers to develop innovative approaches within their Medicaid programs, and to states responding to the additional innovative flexibility authorized through waivers to Affordable Care Act (ACA) provisions.

In partnership with state agencies, we navigate waiver processes from start to finish. In particular, we have significant expertise in guiding state Medicaid agencies through the process of obtaining demonstration waivers under Section 1115 and home- and community-based services (HCBS) waivers under Section 1915 (c). Our team has also consulted with states applying for Balancing Incentive Program funding to promote a more diverse, balanced array of long-term services and supports options for those eligible for them.

Waiver services include:

  • Conducting statewide procurements
  • Designing comprehensive or discrete waiver programs
  • Performing budget neutrality analyses
  • Drafting all waiver documents, including waiver proposals and amendments
  • Assessing strategies for obtaining necessary and timely federal approvals
  • Advising states on how best to implement and finance waiver programs
  • Negotiating with CMS on behalf of states seeking policy and program changes
  • Developing stakeholder communication strategies

Learn more about our MassHealth 1115 waiver projects: