A review of Medicaid 1115 demonstration waivers and amendments submitted by states between January 2017 and May 2018 found lack of consistency and transparency in the Centers for Medicare & Medicaid Services (CMS) processes. The review was conducted by the Government Accountability Office (GAO), which analyzed 11 CMS approvals of new demonstrations and extensions and 21 amendments submitted by 17 states. CMS conducted inconsistent reviews to determine whether the new applications and renewal requests complied with federal transparency requirements; some applications were deemed complete although they lacked expected changes in enrollment, which is required. CMS was inconsistent in its transparency . . .