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In a letter dated April 10, 2025, the Centers for Medicare & Medicaid Services (CMS) notified states that it does not anticipate approving new state proposals for Section 1115 Demonstration expenditure authority for Designated State Investment Programs (DSHP) or Designated State Investment Programs (DSIP) or renewing existing Section 1115 Demonstration expenditure authority for DSHPs or DSIPs.

The Center for Medicaid and CHIP Services (CMCS) will conduct direct outreach to states with existing DSHP and DSIP authority to emphasize that the time-limited authority for DSHPs or DSIPs will not be extended beyond the currently approved demonstration period or, when current . . .

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