In response to the Government Accountability Office's long-standing concerns about the budget neutrality of Medicaid 1115 waivers, CMS on Wednesday (Aug. 22) released its first formal guidance explaining how states must make sure demonstrations won't increase costs to the federal government Comptroller General Gene Dodaro, who heads GAO, and CMS Administrator Seema Verma testified side-by-side at a Senate Homeland Security & Governmental Affairs Committee hearing shortly before CMS released the budget neutrality guidance, and both expressed concerns about states gaming...