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Section 1915(b) of the Social Security Act provides states with the flexibility to modify their delivery systems by allowing CMS to waive statutory requirements for comparability, statewideness, and freedom of choice.

Update: December 10, 2019
The Department seeks to continue its authority, through this second waiver renewal request Adobe Acrobat Reader Symbol, to mandate those enrollees who could previously elect to receive their state plan services through fee-for-service delivery system, pursuant to at 42 CFR 438.50(d)(1-3), to enroll with an MCO to receive their state plan services.

The Department will accept public comments on the proposed waiver renewal until midnight December 27, 2019. Public comment can be submitted to


Update: March 28, 2018

On March 23, 2018, CMS approved the State’s request Adobe Acrobat Reader Symbol for the renewal of the 1915(b) waiver Adobe Acrobat Reader Symbol, to allow the state to provide mandatory enrollment in a managed care delivery system for voluntary populations. The waiver was approved for a 2 year period effective April 1, 2018 through March 31, 2020.

Adobe Acrobat Reader Symbol Adobe Acrobat Reader format. You can download a free reader from Adobe.


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New Hampshire Department of Health and Human Services
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