Department of Medical Assistance Services
GAP Program for the Seriously Mentally Ill §1115 Waiver Application
What is an §1115 waiver?
State Medicaid Programs (Department of Medical Assistance Services (DMAS) in Virginia) may request from the Centers for Medicare and Medicaid Services (CMS) a waiver of specific federal Medicaid requirements that are found in the Social Security Act. There are many types of waivers that a state can seek, but the §1115 Waiver is used to relax certain requirements in order to provide states an avenue to test and implement coverage through innovative program designs that do not meet federal program rules.
Summary of Virginia’s §1115 Waiver - GAP Program for the Seriously Mentally Ill
Virginia is seeking to waive certain federal rules in order to create a limited benefit package that will enable persons with Serious Mental Illness (SMI) to have access to both behavioral health and primary health services. This is an opportunity to provide some services to adults with SMI who currently have no healthcare coverage.
The services provided will enhance the treatment of both conditions, allow their care to be coordinated among all providers, and significantly decrease the level of their condition. With treatment, adults with SMI and co-occurring or co-morbid conditions can recover and live, work, parent, learn and participate fully in their community.
The three key goals of this Demonstration are:
1. Improve access to health care for a segment of the uninsured population in Virginia who have significant behavioral and medical needs;
2. Improve health and behavioral health outcomes of demonstration participants; and
3. Serve as a bridge to Closing the Coverage Gap for uninsured Virginians.
View the 1115 GAP Application submitted to CMS
Bullett Virginia Section 1115 Application GAP Waiver for the Seriously Mentally Ill
View Public Comment Document
Bullett §1115 Waiver Public Comment Document for the GAP Program for the Seriously Mentally Ill
Bullett PDF – 1115 Waiver Public Hearing Presentation
Bullett DMAS Public Comment Response
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Public Meetings
DMAS held two public, in person meetings where stakeholders verbally submitted their public comments regarding the §1115 Waiver Public Comment Document for the GAP Program for the Seriously Mentally Ill. State staff was in attendance at these meetings.
Meeting 1: September 16th from 1:00-3:00pm Location: the Fairfax County Government Center Board of Supervisors Auditorium 1200 Government Center Parkway Fairfax, VA 22035
Meeting 2: September 17th from 1:00-3:00pm Location: the Department of Motor Vehicles (DMV) Richmond Central Office Conference Room 702 2300 West Broad Street Richmond, VA
Helpful Resources
DMAS will update this resource list as information becomes available.
Bullett Centers for Medicare and Medicaid Services §1115 Waiver Information
Bullett A Healthy Virginia – HealthCare Report