Assisted Living News 2026June19
New Section 1115 Guidance Released
On June 11,
CMS released a state Medicaid director's letter on budget neutrality and section 1115 waivers. One-third of Medicaid spending runs through section 1115 waivers. HR 1 required that the CMS Chief Actuary certifies that Medicaid section1115 waivers are budget neutral compared to the cost of running a Medicaid program absent the waiver. CMS says in the letter: "Overall, CMS’s intended approach to implementing section 1115(g) is tied to CMS’s current policy goals: ideally, section 1115 demonstrations should deliver better outcomes and operate as, or more, efficiently than the existing Medicaid program. This includes an approach to budget neutrality that is expected to reduce overall expenditures in section 1115 demonstrations, thereby reducing federal outlays." This appears to deviate from the existing approach of budget neutrality with a greater focus on achieving cost savings, but CMS notes there will be additional guidance, details and technical assistance prior to their change in approach which starts Jan 1, 2027. LeadingAge is reviewing the letter in more detail and will provide more analysis as needed.
Don’t miss our next Assisted Living Survey Session
LeadingAge Nebraska will be hosting Survey Readiness 365: Staying Ahead of Assisted Living Deficiencies on June 30th. This session is free for members and we will be discussing common areas of deficiency in Assisted Living surveys. This session will provide tips and resources to make your next survey the best one possible! Registration is open now.
Updates from DHHS Survey Department
As a recap of our provider/surveyor call on Wednesday, here are your highlights.










