Waivers & Federal Authorities
Myers & Stauffer helps state Medicaid agencies develop, implement, and manage Medicaid waivers, State Plan Amendments (SPAs), and other federal authorities that support program innovation, delivery system transformation, and improved access to care. Our federal authorities and waiver consulting services span the full lifecycle—from authority selection, waiver and SPA development, CMS engagement, and budget neutrality analysis to implementation, ongoing reporting, compliance, and program evaluation—helping states successfully navigate complex federal requirements and achieve long-term program goals.
Supporting the Full Lifecycle of Federal Authorities
States rely on federal authorities to design, test, and implement Medicaid program changes that improve access, quality, and cost-effectiveness. Myers & Stauffer provides end-to-end support to help states identify, develop, secure approval for, and operationalize the most appropriate federal authorities to achieve their policy and program objectives.
We specialize in translating complex federal requirements into actionable strategies, supporting agencies from initial concept development through Centers for Medicare & Medicaid Services (CMS) approval, implementation, ongoing reporting, and compliance activities. Our team brings deep experience in Medicaid policy, financing, and operations, enabling us to align authority selection with state priorities, delivery system goals, and funding considerations.
How We Support States
We provide comprehensive support across the full continuum of waiver and federal authority initiatives, integrating policy, financial, and operational expertise.
Our services include:
States increasingly rely on multiple authorities simultaneously to achieve policy objectives. We help agencies navigate the complexities of concurrent authorities by aligning program design, financing strategies, operational processes, and reporting requirements across initiatives.
Through our broader consulting services, we ensure authority strategies are aligned with delivery system, financing, and programmatic objectives.
Federal Authority Expertise
Myers & Stauffer supports a range of Medicaid and related federal authorities. We help states determine the most appropriate pathway and align authority selection with program goals, financing strategies, and operational considerations.
We support states pursuing transformative initiatives through authorities such as:
These authorities are frequently used to expand coverage, advance delivery system reforms, address behavioral health and substance use disorder (SUD) needs, implement Health-Related Social Needs (HRSN) initiatives, and test innovative models of care.
Our support spans the full lifecycle of these initiatives, including application development, budget neutrality analyses, stakeholder engagement, CMS negotiations, implementation planning, and ongoing reporting and evaluation.
We assist states in designing, implementing, and maintaining HCBS programs that promote community integration and support individuals with long-term services and supports (LTSS) needs.
Our expertise includes:
We support states in expanding access to community-based care while ensuring compliance with federal requirements and alignment with broader system transformation goals.
We support states in leveraging federal authorities to design and implement Medicaid managed care programs, including:
Our services include authority strategy, managed care program design, procurement alignment, independent assessments, stakeholder engagement, and integration with broader delivery system and payment reforms.
We help states align managed care structures with waiver and SPA strategies, ensuring coordination across financing, service delivery, and regulatory requirements.
State Plan Authorities (SPA) serve as a foundational mechanism for implementing a broad range of Medicaid program changes.
We provide support for:
We help states leverage SPAs as part of a broader strategy to implement sustainable, compliant program changes.
Why Agencies Hire Myers & Stauffer
Our work spans a wide range of policy and programmatic initiatives, including:
We align authority selection and program design with each state’s unique policy goals, operational environment, and stakeholder landscape.
Modern Medicaid programs often operate under multiple federal authorities simultaneously. Demonstration waivers, HCBS authorities, SPAs, and managed care authorities frequently intersect, creating complexities related to financing, operations, reporting, and compliance.
Myers & Stauffer helps states coordinate concurrent authorities to ensure program requirements are aligned, reporting obligations are streamlined where possible, and implementation strategies support broader program goals.
Our integrated approach helps agencies navigate these complexities while maintaining compliance and supporting effective program administration.
With nearly 50 years of experience supporting government health care and human services programs, Myers & Stauffer brings a specialized combination of consulting, financial, and program integrity expertise. Our team includes former state Medicaid officials and subject matter experts who understand both the policy intent and operational realities of federal authorities.
Through our integrated consulting services and delivery system transformation expertise, we help states align federal authorities with broader transformation efforts, ensuring programs are compliant, financially sound, and operationally effective.
Not Sure Which Authority is Right?
States often face multiple options when pursuing program changes. We help agencies evaluate available federal pathways, assess trade-offs, and select the most appropriate authority based on policy objectives, financing considerations, operational readiness, and implementation timelines.
Whether pursuing a targeted State Plan Amendment, a large-scale demonstration waiver, or a coordinated strategy involving multiple authorities, we help agencies identify practical solutions that support long-term program success.
Connect With Our Team
Partner with experts who understand the complexities of health and human services programs. Let us guide your organization through the industry’s unique challenges and opportunities.
Bobby Courtney, MA, MPH, JD
Principal
Email: bcourtney@mslc.com
Phone Number: 317-815-5475
Jerry Dubberly, PharmD
Principal
Email: jdubberly@mslc.com
Phone Number: 404-524-9519
In the Words of our Clients…
Recent Insights
We’re committed to advancing government health care through thought leadership, collaboration, and the open exchange of ideas that drive better outcomes. Explore our latest blogs, client alerts, case studies, and thought leadership to see how our expertise can support your goals.
