North Dakota Health and Human Services (HHS) is seeking public comment on an amendment to the state’s Medicaid 1915(c) waiver for in-home and community-based services. The waiver pays for services that help older adults and adults with physical disabilities who qualify for skilled nursing care to live in their own homes and communities. Comments will be accepted through Thursday, Aug. 21, 2025, at 5 p.m. CT.
The proposed amendment includes rate increases to several in-home services and supports that were approved by North Dakota lawmakers during the 2025 legislative session. Other changes include language updates to waiver regulations and provider qualifications.
Public comment
The draft waiver amendment can be viewed online at hhs.nd.gov/waivers. A copy will be provided upon request.
Comments can be submitted to North Dakota Health and Human Services – Adult and Aging Services Section, Attn: HCBS, 1237 W. Divide Ave., Suite 6, Bismarck, N.D., 58501, dhshcbs@nd.gov, toll-free 855-462-5465, or 711 (TTY).
Individuals who have questions about the proposed waiver amendment can contact Sandi Erber at srerber@nd.gov or 701-328-8915, 711 (TTY).
North Dakotans can get help accessing Medicaid waiver services and other in-home and community-based long-term services and support by contacting the state’s Aging and Disability Resource Link toll-free at 855-462-5465, 711 (TTY) or by email at carechoice@nd.gov. Individuals can also apply for these services online or search the online database at carechoice.nd.assistguide.net.
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 amendment is expected to be effective on Jan. 1, 2026.
Waivers are agreements between CMS and a state's Medicaid agency and serve specific groups of people. Waivers specify the number of people to be served, eligibility criteria, available services, including any limits on services; and procedures for the evaluation and re-evaluation of level of care.