Federal 1135 Waiver to Aid Arkansas’s COVID-19 Response

April 9, 2020


Elizabeth (Izzy) Montgomery, MPA
Policy Analyst

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On March 30, Arkansas submitted a Section 1135 emergency waiver request to the federal government related to the COVID-19 outbreak in the state. Approved on April 2, the waiver will provide flexibility regarding certain requirements of Medicaid, the Children’s Health Insurance Program (CHIP), and federal privacy and security law during the public health emergency.

Under President Trump’s national emergency declaration and the declaration of a national public health emergency, the Health and Human Services secretary can utilize Section 1135 authority to waive regulatory requirements that are not otherwise modifiable outside of an emergency. As of April 2, 44 states have submitted Section 1135 waiver requests in response to the COVID-19 outbreak.

Arkansas’s requests for flexibility are listed in detail in the waiver request letter submitted by the Arkansas Department of Human Services. Key requests include:

  • Allowing hospitals to provide services in alternative settings.
  • Allowing expanded payment to providers for telemedicine services.
  • Allowing telemedicine services to be provided at rural health clinics.
  • Waiving critical access hospitals’ bed limits (currently 25 beds) and length-of-stay requirements (average of 96 hours or less).
  • Allowing hospital-based providers to reuse face masks during the same work shift.
  • Waiving the requirement that physicians and other healthcare professionals be licensed in the state in which they are providing services (so long as they have equivalent licensing in another state).
  • Permitting 90-day supplies of medications at both retail and mail-order pharmacies.

These flexibilities are expected to enable Arkansas to better ensure continuity of routine care, address personal protective equipment shortages happening nationally, and plan for an anticipated surge of patients with COVID-19.

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