From page A-27: “On June 29, 2007, the Commonwealth submitted an application to CMS to renew the waiver through June 30, 2011. The provisions of the waiver will guide how the Commonwealth moves forward in designing not
only the Medicaid program, but also the broader health care reform initiative, including the Commonwealth Care program and Health Safety Net Trust Fund. As such, the waiver agreement will reflect the federal reimbursement the
Commonwealth can expect for several important programs, including (but not limited to):
• Medicaid waiver populations (i.e., individuals that are not eligible under traditional Medicaid rules, but for
which CMS has agreed to allow eligibility)
• Commonwealth Care
• Health Safety Net Trust Fund
• Hospital Supplemental Payments
• Children’s Behavioral Health Services (specifically related to the Rosie D. et al v. Romney lawsuit. See
“LEGAL MATTERS.”)

One condition of the 1115 waiver is that the cost of services provided under the waiver must not exceed the cost of the traditional Medicaid program if a waiver had not been granted. The Commonwealth must periodically submit statements of “budget neutrality” in order to affirm that the state has not violated this provision of the waiver agreement. The Commonwealth submitted a budget neutrality statement to CMS in support of the renewal application on December 24, 2007. Discussions with CMS to finalize the terms of the waiver are ongoing, and the Commonwealth’s goal is to have a new agreement in place by July 1, 2008.”