Senate committee hears update on Alaska’s Medicaid 1115 behavioral health waiver

Deputy Commissioner Emily Ricci and Division of Behavioral Health Director Tracy Dompling told the Senate Health & Social Services Committee on Jan. 30 that Alaska’s Medicaid 1115 demonstration—now the Behavioral Health Reform Waiver—was renewed and remains a primary vehicle for expanding behavioral health services and drawing federal funds.

The waiver, which the department described as a federal demonstration authority under Social Security Act §1115, was renewed on March 26, 2024, and will run through Dec. 31, 2028. The Department of Health officials said the waiver has brought services into Medicaid that previously relied on grants and has increased both provider participation and total behavioral health spending.

The 1115 authority allows the U.S. Department of Health and Human Services to approve time-limited demonstrations that depart from the state plan to test policies. "The 1115 waiver really refers to a section of the Social Security Act that gives the Secretary of Health and Human Services an opportunity to allow states the flexibility to cover different services or to cover different individuals," Emily Ricci said. She and other presenters emphasized that 1115 demonstrations must be budget neutral to the federal government, are typically approved for up to five years, and require independent evaluation and significant federal negotiation and…