State Proposals

A total of 26 states submitted proposals by the deadline of May 31, 2012, and those with active proposals are listed below. Submission of a demonstration proposal is an important step - but not the final step - toward demonstration approval. The proposals below include capitated, managed fee-for-service (FFS), and alternative models.

States interested in the new financial alignment opportunities were required to submit a letter of intent by October 1, 2011. 

• States that Submitted Letters of Intent to Apply (PDF)

When a state meets the standards and conditions for the Financial Alignment Initiative, the Centers for Medicare & Medicaid Services (CMS) and a state will develop a memorandum of understanding (MOU) to establish the parameters of the initiative. 

To access the signed MOUs, click on the dates listed in the chart below, under the column labeled "MOU Signed."

• View the Approved Demonstrations and Signed MOUs

Standards and Conditions

As indicated in the State Medicaid Director (SMD) letter, demonstration proposals are evaluated against standards and conditions that CMS is requiring of all states seeking to participate in the demonstration.

• Demonstration Standards and Conditions (February 2012) (PDF)

Public Comments

As part of the proposal review process, CMS hosted a public comment period for each proposal. These periods have closed, but interested parties can still review the proposals above and read the public comments submitted to CMS.

• Read Public Comments Submitted to CMS

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