States’ applications for federal Medicaid waivers often lack transparency, according to a new report by the U.S. Government Accountability Office.

According to the GAO, the chief problem with the transparency of state applications for Medicaid waivers arises when states either seek to amend waivers they have already obtained or amend waiver applications currently under review by the Centers for Medicare & Medicaid Services.  Too often, the GAO found, states neither subject such amendments to public review and comment nor adequately explain to stakeholders the implications of the amendments they are proposing.

To address this problem, the GAO recommends that CMS address these shortcomings.  CMS agrees with these recommendations.

States often use section 1115 Medicaid waivers to seek exemptions from selected aspects of federal Medicaid law so they can employ new approaches to the delivery of Medicaid services and to payment for those services. Because they serve so many more Medicaid patients than most hospitals, private safety-net hospitals have a much greater stake in changes in state Medicaid programs than other hospitals.

Learn more about why the GAO undertook this analysis and what it found in its report Medicaid Demonstrations:  Approvals of Major Changes Need Increased Transparency.