CMS rejects Ohio's 1115 waiver over premium concerns

CMS has rejected Ohio's 1115 waiver application, known as the Health Ohio Program, because of concerns its proposed premiums for Medicaid beneficiaries could negatively impact members' health.

Ohio submitted the 1115 waiver June 15, 2016. The proposal would have implemented a number of changes to its Medicaid program starting in January 2018 through December 2022.

Changes included imposing monthly contributions for beneficiaries equal to either 2 percent of their annual income or $99 per year. The program would disenroll members who failed to pay their monthly contribution and bar them for coverage for the next year.

In it's rejection letter, CMS specifically cited concerns over the state's request to charge low-income beneficiaries premiums to be eligible for coverage.

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