CMS Rescinds Fast-Track Review Process for Section 1115 Demonstration Extensions
CMS issued an informational bulletin on July 7, 2026, rescinding the fast-track federal review process for Section 1115 demonstration extensions. States seeking to extend existing Section 1115 demonstrations must now follow standard CMS review timelines and procedures, which typically require full public notice and comment periods and can take six months or longer. The rescission is effective immediately and applies to all pending and future extension requests. This change affects states with demonstrations expiring soon that planned to use expedited procedures, requiring them to build additional lead time into their extension planning and potentially delaying implementation of continuation authority.
States must now allow significantly more lead time for demonstration extensions, potentially creating coverage or administrative continuity risks for demonstrations expiring in the next 12-18 months that anticipated fast-track approval.
Managed Care · LTSS · Behavioral Health
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