CMS approved parts of the state of Washington’s COVID-19 section 1115 waiver request that aligned with CMS’ COVID-19 Section 1115 demonstration opportunity guidance and checklist template. CMS is still reviewing several aspects of the request (e.g., the establishment of a disaster relief fund to pay providers for uncompensated care related to COVID-19) and denied its request to establish a temporary eligibility group for individuals with incomes at or below 200% of the FPL. In deferring approval, CMS noted that a number of Washington’s requests may be approvable under a Medicaid Disaster state plan amendment (SPA) or Appendix K for 1915(c) waivers. This is the first approval of 1115 waiver authority related to the COVID-19 response.