Definitions for "Section 1915 Waiver"
A statutory provision that allows a State to partially limit the choice of providers for Medicaid enrollees; for example, under the waiver, a State can limit the number of times per year that enrollees can choose to drop out of an HMO.
Freedom of choice or Section 1915(b) waivers allow states to place beneficiaries in a primary care case management program (PCCM), which is run on a "managed" fee-for-service basis using a gatekeeper concept, or in a prepaid capitated arrangement.
Under section 1915(b) of the Social Security Act, the Secretary of HHS is authorized to waive compliance with the "freedom of choice" and "statewideness" requirements of federal Medicaid law in order to allow states to operate mandatory managed care programs in all or portions of the state while continuing to receive federal Medicaid matching funds. The waivers, which are granted (or renewed) for 2-year periods, are administered by HCFA. Waiving other provisions of Medicaid law requires a section 1115 waiver.