Louisiana Anticipates CMS Approval for 1115 Prison Reentry Demonstration Waiver

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- Louisiana anticipates 1115 Prison Reentry Demonstration Waiver approval after aligning with new federal requirements

April 15, 2026 Louisiana anticipates 1115 Prison Reentry Demonstration Waiver approval after aligning with new federal requirements Demonstration helps ensure Medicaid-eligible incarcerated individuals receive continuity of care as they transition into the community

Baton Rouge, Louisiana,

Apr 15, 2026

• Governor Jeff Landry today announced that Louisiana anticipates approval later this year from the Centers for Medicare & Medicaid Services (CMS) of its Section 1115 Medicaid Reentry Demonstration Waiver. Louisiana was the first state in the nation to align its waiver to reflect new federal requirements under Sec. 71118 of H.R. 1 (OBBBA). This requirement establishes budget-neutrality mandates for Medicaid demonstration projects beginning on January 1, 2027.

The waiver, currently under review by the Centers for Medicare & Medicaid Services (CMS), reflects close coordination between the State of Louisiana and federal partners. Louisiana worked with CMS to identify alternative funding sources for the infrastructure needed to implement the waiver.

The Section 1115 Reentry Demonstration is designed to improve health outcomes for individuals transitioning from incarceration to their communities by connecting them to Medicaid coverage and critical pre-release services prior to release. The initiative focuses on improving continuity of care, particularly for individuals with mental health and substance use disorders.

Many experience disruptions in care during incarceration and face elevated risks upon release, including overdose, emergency department utilization, and unmet behavioral health needs.

Louisiana’s proactive approach positions the state at the forefront of Medicaid innovation while strengthening alignment with evolving federal policy and reinforcing a shared commitment with CMS to accountable, outcomes-driven demonstration design.

“This work reflects Louisiana’s commitment to planning ahead and working in partnership with CMS to strengthen our health care system,” said Governor Jeff Landry. “By proactively aligning with upcoming federal requirements, we are ensuring our state is prepared for the future while staying focused on helping people successfully transition back into their communities and rebuild their lives.”

“Through this effort, we’re going to help move Louisianans from dependence to independence while saving taxpayer dollars, reducing emergency department use, and seeing fewer people going back to jail,” said Louisiana Department of Health (LDH) Secretary Bruce Greenstein. “This demonstration strengthens coordination with CMS, the Louisiana Department of Public Safety and Corrections (DOC), and community partners while improving access to care during one of the most critical transition points in a person’s life.”

Through the demonstration, eligible individuals will receive a range of pre-release services, including case management, behavioral health treatment, medication-assisted treatment for substance use disorders, medication supply upon release, and connections to community-based providers.

This project will help coordinate care across LDH, correctional facilities, managed care organizations, and community providers to ensure smoother transitions after release from jails and prisons.

Once approved, Louisiana will implement the demonstration through a phased, milestone-driven approach, prioritizing rollout at the eight state prison facilities operated by DOC, followed by expansion to parish jails based on readiness.