Embedded Files
Saipan Walk-In Hours: Mon-Thurs, 8:30 AM to 4:00 PM. Please feel free to visit us during these hours for assistance or contact us at (670) 664-4880.
About the 1115 Demonstration Waiver
About the 1115 Demonstration Waiver
The Section 1115 Demonstration Waiver is a federal authority granted by the Centers for Medicare & Medicaid Services (CMS) that allows states and territories to test innovative approaches in their Medicaid programs. These demonstration projects explore new ways to deliver services, improve health outcomes, expand access, and address community health needs — even if those approaches differ from standard Medicaid requirements.
In the Commonwealth, the Medicaid Agency supports this process by facilitating applications and administering funding for demonstration projects proposed by eligible organizations, agencies, or partners. Through this collaborative approach, innovative ideas can be brought forward, reviewed, and — if approved by CMS — implemented to benefit Medicaid beneficiaries across the CNMI.
Our Role
Our Role
The Commonwealth Medicaid Agency serves as the primary point of contact for entities seeking to pursue a Section 1115 Demonstration Waiver project.
We:
Facilitate the application process and guide organizations through submission requirements.
Administer Medicaid funding to support approved demonstration projects in line with federal standards.
Coordinate with CMS and project partners to ensure compliance, accountability, and successful implementation.
Monitor and evaluate outcomes to assess project impact and inform future program decisions.
This structure allows local partners to design and implement demonstration projects that meet community needs — with CMA providing the support, coordination, and funding necessary for success.
Purpose and Goals
Purpose and Goals
The Section 1115 Demonstration Waiver process creates opportunities to:
Test Innovative Solutions: Pilot new approaches to care delivery and program design.
Improve Access to Care: Expand Medicaid services to reach more individuals and families.
Advance Health Equity: Address disparities and improve outcomes in underserved populations.
Promote Sustainability: Explore models that improve quality and efficiency while remaining budget neutral.
Why It Matters
Why It Matters
Every community faces unique health challenges. Section 1115 Demonstration Waivers make it possible to design solutions that respond directly to the needs of the CNMI. By supporting these projects, the Commonwealth Medicaid Agency helps:
Strengthen care delivery and coordination.
Address local population health priorities.
Improve outcomes and access for Medicaid beneficiaries.
Inform future program strategies and policies.
How to Apply
Eligible organizations and agencies interested in pursuing a Section 1115 Demonstration Waiver project can submit an application through the Commonwealth Medicaid Agency. Approved proposals are then submitted to CMS for review and authorization. Click the links below to access the Letter of Instruction (LOI) and 1115 Demonstration Waiter Application.
The Letter of Instruction explains how to prepare and submit your Section 1115 Demonstration Waiver application, including key requirements, timelines, and next steps.
The Application is the required form for organizations and agencies seeking to propose a Section 1115 Demonstration Waiver project. It collects essential information about your proposal, goals, and implementation plan for review and submission to CMS.
1115 Application Process
1115 Application Process
This page from the Centers for Medicare & Medicaid Services (CMS) outlines the application process for §1115 demonstration waivers under the Medicaid program — including required components for initial submissions, extensions of existing demonstrations, and fast-track reviews during the COVID-19 public health emergency.
Page updated
Report abuse