LEGISLATIVE SERVICES AGENCY
OFFICE OF FISCAL AND MANAGEMENT ANALYSIS
FISCAL IMPACT STATEMENT
LS 7082 NOTE PREPARED: Jan 3, 2025
BILL NUMBER: SB 534 BILL AMENDED:
SUBJECT: Medicaid Waiver for Reimbursement for Food.
FIRST AUTHOR: Sen. Yoder BILL STATUS: As Introduced
FIRST SPONSOR:
FUNDS AFFECTED:XGENERAL IMPACT: State
DEDICATED
XFEDERAL
Summary of Legislation: The bill requires the Office of the Secretary of Family and Social Services to
apply for a Medicaid waiver to allow for Medicaid reimbursement for food and meals.
Effective Date: July 1, 2025.
Explanation of State Expenditures: Depending on the design of the demonstration waiver, costs could
increase up to 3% of total annual Medicaid spending to reimburse food and meals, as health-related social
needs (HRSN) for at- risk populations.
The bill's requirements for the Family and Social Services Administration to apply for a Section 1115
demonstration waiver are within the agency's routine administrative functions and should be able to be
implemented with no additional appropriations, assuming near customary agency staffing and resource levels.
Additional Information - The Section 1115 demonstration waivers for HRSN services expenditures are
capped at 3% of the state's total annual Medicaid spending, potentially increasing the state's share of
Medicaid costs. However, the Centers for Medicare and Medicaid Services (CMS) also allows states to use
federal Medicaid funds to supplant state dollars for certain designated state health program, up to 1.5% of
the state's total Medicaid spending on these programs. This would allow the state to offset some of the
increased cost for HRSN services. Other CMS conditions for these waivers may have minimal impacts on
the state's share of costs for this type of waiver.
Explanation of State Revenues:
Explanation of Local Expenditures:
Explanation of Local Revenues:
State Agencies Affected: Office of the Secretary of Family and Social Services.
SB 534 1 Local Agencies Affected:
Information Sources: Hinton, Elizabeth; Diana, Amaya, Section 115 Medicaid Waiver Watch: A Closer
Look at Recent Approvals to Address Health-Related Social Needs (HRSN), Kaiser Family Foundation,
March 4, 2024;
Mann, Cindy; Lipson, Mindy, CMS' New Policy Framework for Section 1115 Medicaid Demonstrations, The
Commonwealth Fund Blog, January 10, 2023;
Centers for Medicare and Medicaid Services, State Waiver database, accessed September 17, 2024.
Fiscal Analyst: Karen Rossen, 317-234-2106.
SB 534 2