PUBLIC NOTICE November 21, 2025 Pursuant to the provisions of Title 42 Section 441.304(f), Code of Federal Regulations, public notice is given regarding the submission of the Medically Fragile Adult Waiver renewal. The Centers for Medicare & Medicaid Services (CMS) requires states to obtain public input during the development of a waiver, a waiver renewal or a waiver amendment with substantive changes. Stakeholders are being asked to provide public input and comment in order to allow Missouri to submit this waiver renewal. Please see a complete draft of the waiver renewal on the MO HealthNet Division website under Alerts and Public Notices at: https://mydss.mo.gov/mhd/alerts. Written Public Comments The MO HealthNet Division will accept written public comments until the end of business day December 21, 2025. Comments will be summarized for CMS. Written public comments may be mailed or e-mailed to: MO HealthNet Division PO Box 6500 Jefferson City, MO 65102-6500 Attn: MO HealthNet Director Email: Ask.MHD@dss.mo.gov Complete copies of the waiver renewal draft are available on-line at https://mydss.mo.gov/mhd/alerts, or by request from DHSS/DSDS' Central Office; by phone at (573) 526-8557; in person at 912 Wildwood Dr., Jefferson City, MO 65102; or by mail at PO Box 570, Jefferson City, MO 65102-0570. IPL0291348 Nov 21 2025