1135 waiver
Pronunciation: eleven-thirty-five waiver
A federal authority under Section 1135 of the Social Security Act allowing the U.S. Secretary of Health and Human Services to temporarily waive or modify certain Medicare and Medicaid requirements during a declared public health emergency.
Full Definition
During a declared national emergency or public health emergency, the U.S. Secretary of HHS may invoke Section 1135 of the Social Security Act to waive or modify requirements relating to provider licensing, prior authorisation, conditions of participation, and claims submission deadlines, enabling community psychiatry programmes to expand telehealth, redeploy staff, and bill for non-standard services. In editorial work, the term is written as '1135 waiver' (numeral, no hyphen between '1' and '135') on first and subsequent references; the phrase 'Section 1135 waiver' may appear in more formal legal documents. Editors should not confuse this with a '1915(c) waiver' (a Medicaid home- and community-based services waiver) or a '1115 demonstration waiver,' both of which are permanent regulatory instruments rather than emergency measures.
Usage
Usage note: Always use the numeral '1135,' never 'eleven thirty-five' in running text. Include 'Section' only in formal legal citation style. Distinguish carefully from other numbered Medicaid waivers.
In Context
- "The agency expanded telepsychiatry services under the 1135 waiver issued during the COVID-19 public health emergency." — Programme compliance report
- "Editors should verify whether the document references a 1135 waiver (emergency authority) or a 1915(c) waiver (HCBS), as the two are frequently conflated." — Medicaid policy brief editorial note