Also known as the Home- and Community-based Services Waiver (HCBS), this waiver authorizes the Secretary of HHS to allow a state Medicaid program to offer a special package of services to individuals at risk for institutionalization or hospitalization. These home and community-based services, which otherwise would not be covered with federal matching funds, include case management, homemaker/home health aide services, personal care services, adult day health services, habilitation services, and respite care. A number of states have waiver programs specifically for individuals with AIDS. In some cases, eligibility for waiver programs is more generous than the traditional Medicaid programs.
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 CMS. Connecticut currently operates its HUSKY A managed care program under a 1915(b) 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 choice of enrollees to disenroll from an HMO on more than a yearly basis.