42 U.S.C. § 1315
Section 1315 · Demonstration projects
Current version, with additions and removals from the September 29, 2014 version.
An application or renewal of any experimental, pilot, or demonstration project undertaken under subsection (a) to promote the objectives of subchapter XIX or XXI in a State that would result in an impact on eligibility, enrollment, benefits, cost-sharing, or financing with respect to a State program under subchapter XIX or XXI (in this subsection referred to as a “demonstration project”) shall be considered by the Secretary in accordance with the regulations required to be promulgated under paragraph (2).
Not later than 180 days after March 23, 2010, the Secretary shall promulgate regulations relating to applications for, and renewals of, a demonstration project that provide for—
a process for public notice and comment at the State level, including public hearings, sufficient to ensure a meaningful level of public input;
requirements relating to—
the goals of the program to be implemented or renewed under the demonstration project;
the expected State and Federal costs and coverage projections of the demonstration project; and
the specific plans of the State to ensure that the demonstration project will be in compliance with subchapter XIX or XXI;
a process for providing public notice and comment after the application is received by the Secretary, that is sufficient to ensure a meaningful level of public input;
a process for the submission to the Secretary of periodic reports by the State concerning the implementation of the demonstration project; and
a process for the periodic evaluation by the Secretary of the demonstration project.
The Secretary shall annually report to Congress concerning actions taken by the Secretary with respect to applications for demonstration projects under this section.
An application or renewal of any experimental, pilot, or demonstration project undertaken under subsection (a) to promote the objectives of subchapter XIX or XXI in a State that would result in an impact on eligibility, enrollment, benefits, cost-sharing, or financing with respect to a State program under subchapter XIX or XXI (in this subsection referred to as a “demonstration project”) shall be considered by the Secretary in accordance with the regulations required to be promulgated under paragraph (2).
Not later than 180 days after March 23, 2010, the Secretary shall promulgate regulations relating to applications for, and renewals of, a demonstration project that provide for—
a process for public notice and comment at the State level, including public hearings, sufficient to ensure a meaningful level of public input;
requirements relating to—
the goals of the program to be implemented or renewed under the demonstration project;
the expected State and Federal costs and coverage projections of the demonstration project; and
the specific plans of the State to ensure that the demonstration project will be in compliance with subchapter XIX or XXI;
a process for providing public notice and comment after the application is received by the Secretary, that is sufficient to ensure a meaningful level of public input;
a process for the submission to the Secretary of periodic reports by the State concerning the implementation of the demonstration project; and
a process for the periodic evaluation by the Secretary of the demonstration project.
The Secretary shall annually report to Congress concerning actions taken by the Secretary with respect to applications for demonstration projects under this section.
Beginning January 1 2027, the Secretary may not approve an application for (or renewal or amendment of) an experimental, pilot, or demonstration project undertaken under subsection (a) to promote the objectives of subchapter XIX in a State (in this subsection referred to as a “Medicaid demonstration project”) unless the Chief Actuary for the Centers for Medicare & Medicaid Services certifies that such project, or, in the case of a renewal, the duration of the preceding waiver, is not expected to result in an increase in the amount of Federal expenditures compared to the amount that such expenditures would otherwise be in the absence of such project. For purposes of this subsection, expenditures for the coverage of populations and services that the State could have otherwise provided through its Medicaid State plan or other authority under subchapter XIX, including expenditures that could be made under such authority but for the provision of such services at a different site of service than authorized under such State plan or other authority, shall be considered expenditures in the absence of such a project.
In the event that expenditures with respect to a State under a Medicaid demonstration project are, during an approval period for such project, less than the amount of such expenditures that would have otherwise been made in the absence of such project, the Secretary shall specify the methodology to be used with respect to the subsequent approval period for such project for purposes of taking the difference between such expenditures into account.