Gov. Kemp, DCH announce approval of 1135 Medicaid and PeachCare for Kids® Waiver

Gov. Brian P. Kemp and the Georgia Department of Community Health (DCH) today announced that the Centers for Medicare and Medicaid Services (CMS) approved Georgia’s section 1135 waiver request on the temporary checklist, granting the state a number of flexibilities for Medicaid and PeachCare for Kids® providers and members to combat the COVID-19 public health emergency. To read the approval letter, click HERE.

“We want to thank CMS for granting this waiver to provide the resources and flexibility for our health care systems and heroic health care workers to fight COVID-19,” said Gov. Kemp. “The safety of Georgians is my top priority, and this measure helps ensure access to health care for some of our state’s most vulnerable citizens during this unprecedented time.”

“The Department of Community Health is grateful to our federal partners for moving so quickly to provide regulatory relief and support to our health care systems,” said DCH Commissioner Frank Berry. “We also greatly appreciate the work of our providers in helping us to explore creative avenues to ensure the best care to our citizens.”

Included in the approval of template checklist flexibilities under the 1135 waiver are:

§  Temporary suspension of Medicaid fee-for-service prior authorization requirements for particular benefits

§  Extension of pre-existing prior authorizations

§  Suspension of Pre-Admission Screening and Annual Resident Review (PASRR) Level I and Level II assessments for 30 days

§  Extension of state fair hearing requests and appeal timelines

§  Authorization for Georgia Medicaid to provisionally, temporarily enroll out-of-state providers who are enrolled in another state’s Medicaid program or Medicare

§  Waiver of application fees, criminal background checks, site visits and in-state licensure requirements for providers not already enrolled in another state’s Medicaid program or Medicare

§  Authorization for Georgia Medicaid to temporarily cease re-validation of providers

§  Authorization for the provision of services in alternative settings

The approval of these temporary flexibilities is effective retroactively to March 1, 2020 and ends upon termination of the public health emergency, including any extensions, according to CMS.

Additional provisions requested in Georgia’s 1135 waiver are still pending CMS review and approval. Updates will be provided on those pending items as more information becomes available.