CMS Approves CalAIM Medicaid Waiver

On December 29, 2021, the Centers for Medicare & Medicaid Services (CMS) approved the California Advancing and Innovating Medi-Cal (CalAIM) Medicaid waiver amendment and renewal for the state’s Medicaid 1115 demonstration and 1915(b) waiver, effective January 1, 2022, through December 31, 2026. The previous waiver expired December 31, 2021. The CalAIM provisions are intended to standardize Medicaid managed care plan benefits; to add institutional care and major organ transplants into managed care; to carve pharmacy out of Medi-Cal health plan managed care; and to implement Medicaid managed long-term services and supports (MLTSS) statewide.

The state . . .