NC Section 1115 Demonstration Waiver

North Carolina is seeking to renew its Medicaid Reform Demonstration for another five-year period. During the first demonstration period, North Carolina began its transition to managed care and invested in novel programs to better respond to the diverse needs of North Carolinians who are enrolled in Medicaid.

North Carolina is now ready to build on early successes and lessons learned to continue this progress over the next five years. The State’s overarching goal for the demonstration is to improve health and well-being for all North Carolinians through a whole-person, well-coordinated system of care that addresses both medical and non-medical drivers of health and advances health access by reducing disparities for historically marginalized populations.

Proposed Effective Dates for Demonstration Renewal: November 1, 2024 to October 31, 2029.

NC Section 1115 Demonstration Waiver Application

Proposed Drafted Application including Evaluation Reports
Previously Approved Application
Full public notice 
Abbreviated public notice 

Fact Sheets

NC 1115 Waiver Renewal Fact Sheet
NC 1115 Waiver Renewal Healthy Opportunities Pilot Fact Sheet
NC 1115 Waiver Renewal Justice-involved Fact Sheet

For more information on the pending SUD waiver extension request, please visit this webpage.

Opportunities for Public Comment

North Carolina invites public comments on the North Carolina Medicaid Reform Demonstration renewal application from August 21, 2023 through September 20, 2023. 

To be assured consideration prior to submission of this demonstration renewal request, comments must be received by 5 p.m. EST, September 20, 2023. 

Written comments may be sent to the following address (please indicate “NC Section 1115 Waiver” in the written message): 

North Carolina Department of Health and Human Services 
NC Medicaid Section 1115 Waiver Team 
1950 Mail Service Center 
Raleigh, NC 27699-1950

Comments may also be emailed to Please indicate “NC Section 1115 Waiver” in the subject line of the email message.

You may request a copy of the proposed renewal request, notices and/or a copy of submitted public comments, once available, related to the Medicaid Reform Section 1115 Demonstration renewal by requesting it in writing to the mailing or email addresses listed above.  

Interested parties will also have the opportunity to officially comment on the demonstration renewal application during the federal public comment period; the submitted application will be available for comment on the CMS website at

Public Hearings

To ask questions about accessibility or request accommodations, please email At least two weeks' advance notice will help us to provide seamless access.

North Carolina will host five public hearings to seek input regarding the waiver extension request:

First Public Hearing (in person)

Sept. 5 from 9:30-11 a.m. EST
Mountain Area Health Education Center (MAHEC)
Blue Ridge A & B in the Education Building
121 Hendersonville Road, Asheville NC 28803


Second Public Hearing (in person)

Sept. 6 from 9:30 -11 a.m. EST
McKimmon Conference & Training Center
NC State University, 1101 Gorman Street, Raleigh NC 27606


Third Public Hearing

Sept. 6 from 5:30-7:00 p.m. EST
Virtual via Microsoft Teams 

Meeting video 

Fourth Public Hearing (in person)

Sept. 7 from 2:30-4 p.m. EST
Greenville Convention Center
303 SW Greenville Blvd., Greenville NC 27834


Fifth Public Hearing

Sept. 15 from 11:30 a.m.-12:30 p.m., EST During the Medical Care Advisory Committee Meeting (MCAC)
Virtual via Microsoft Teams Join on your computer, mobile app or room device 
Click here to join the meeting 
Call in (audio only) 
+1 984-204-1487, 412615457#  United States, Raleigh 
Phone Conference ID: 412 615 457#