I was interviewed by Bloomberg Law about statutory constraints on the ability of the Secretary of the Department of Health and Human Services to issue waivers under Section 1115 of the Social Security Act for Medicaid experimental, pilot or demonstration projects that involve block grants. Such waivers must be likely to promote the objectives of the Medicaid program. Obtaining value for dollars spent seems fundamental to the purposes of Medicaid. Obtaining maximal value for those dollars is inextricably linked to incentives built into the payment structure and is part of the justification for the waiver program. Each application would need to be judged on its merits, but as long as these waivers are initiated by states themselves, the federal government continues to provide the required matching dollars, and the state is in compliance with other aspects of the Medicaid Statute (for example if the waiver includes provisions that would reduce waste, fraud and abuse to free up dollars for other purposes), the Secretary has the authority to approve them. https://news.bloomberglaw.com/health-law-and-business/medicaid-block-grant-policy-could-face-high-legal-hurdles