Medicaid Section 1115 Demonstration Five-Year Renewal & Amendment Request: CalAIM Demonstration

The California Department of Health Care Services (DHCS) released the draft California Advancing & Innovating Medi-Cal (CalAIM) waiver on April 6, 2021, to begin a public comment period before the waiver is submitted for federal approval. The CalAIM provisions are intended to standardize Medicaid managed care plan benefits, add institutional care and major organ transplants into managed care, and carve pharmacy out of managed care. Through CalAIM, the state also intends to implement Medicaid managed long-term services and supports (MLTSS) statewide, which will replace the state’s current 1915(b) Medicaid waiver plans, which have capped enrollment and . . .