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Page 2 – Ms. Karen Kimsey

CMS’s approval of this section 1115(a) demonstration amendment is subject to the limitations specified in the attached expenditure authorities, STCs, and any supplemental attachments defining the nature, character, and extent of federal involvement in this project. The Commonwealth may deviate from Medicaid and CHIP state plan requirements only to the extent those requirements have been specifically listed as waived or not applicable under the demonstration.

Consideration of Public Comments

The Commonwealth provided public notice for this amendment in accordance with the processes described in the September 27, 1994 Federal Register notice (59 FR 49249) as generally acceptable methods of state public notice for demonstration amendments. CMS generally considers a state to have provided acceptable public notice if the state provides for a formal notice and comment process on the section 1115 proposal in accordance with the state’s administrative procedure act; provided that such notice is given at least 30 days prior to submission to CMS. Accordingly, Virginia conducted a 31-day public comment period and held one virtual meeting for the public to provide input. The Commonwealth received 24 comments from individual members of the public as well as representatives of 20 organizations and all were in support of the amendment.

Virginia also conducted tribal consultation with its seven federally recognized tribes by providing written notice on January 29, 2021 and a 60-day tribal comment period on the proposed amendment. The Commonwealth did not receive any comments from the tribes.

Consistent with the CMS April 27, 2012 State Medicaid Director/State Health Official Letter on the “Revised Review and Approval Process for Section 1115 Demonstrations” (SHO# 12- 001), a federal public comment period was opened from April 7, 2021 to May 7, 2021. CMS received 14 comments that represented 50 enrollee and provider advocacy organizations. All commenters strongly advocated support of the state’s proposal to extend the postpartum eligibility period; providing national and Virginia specific maternal health statistics to promote this amendment as a critical step to reducing maternal mortality and morbidity for lower income individuals as well as racial disparities in maternal and infant health outcomes.

The award is subject to CMS receiving written acceptance of this award within 30 days of the date of this approval letter. Your project officer is Ms. Ticia Jones. Ms. Jones is available to answer any questions concerning implementation of the Commonwealth’s section 1115(a) demonstration and her contact information is as follows:

Centers for Medicare & Medicaid Services Center for Medicaid and CHIP Services Mail Stop: S2-01-16 7500 Security Boulevard Baltimore, Maryland 21244-1850 Email: Ticia.Jones@cms.hhs.gov