North Dakota Health and Human Services (HHS) is now accepting public comment on proposed amendments to the state’s Medicaid autism spectrum disorder (ASD) waiver and the Medicaid waiver for medically fragile children. HHS is seeking federal approval to amend the waivers to reflect recent state legislative changes. Comments will be accepted through July 27, 2025, at 5 p.m. CT.
The ASD waiver provides services to eligible children and supports parents in their efforts to maximize their child’s development, while also preventing out-of-home placements.
The proposed amendments will increase the qualifying age of children who can be served by the waiver from through age 17 to through age 20. The amendment also increases slots to 400 slots per year with 345 active at a time and updates language on services. The North Dakota legislature granted providers a 2% increase in 2025 and a 2% percent increase in 2026. The services affected by the legislative increases are service management (case management) and respite care.
The Medicaid waiver for medically fragile children allows Medicaid to pay for services for children between the ages of 3 to 18 who are medically fragile. The goal of this waiver is to help families keep their children home instead of having to place them in a nursing home or hospital to receive needed care. The waiver is being amended to increase the age of the waiver to age 21 and to increase slots to 75 slots per year with 50 active at a time. All services remain the same.
How to provide public comment
Both draft waivers can be viewed online at hhs.nd.gov/waivers. Copies are also available upon request.
Individuals can submit comments by emailing dhsautism@nd.gov or calling 800-755-2604 or 701-328-4630, or 711 (TTY), or by fax at 701-328-1544. Comments can also be mailed to the North Dakota Health and Human Services Medical Services Division, Attn: Autism Services, 600 E. Boulevard Ave., Dept. 325, Bismarck, ND, 58505-0250.
After the public comment period ends, the waiver will be submitted to the federal Centers for Medicare and Medicaid Services (CMS). Based on the CMS timeframes for review and approval, the waiver is expected to be effective in November 2025.