The Q&As clarify that the MOE provisions do apply to Section 1115 waiver/demonstration projects, but do not require states to renew a section 1115 demonstration upon its specified expiration date. The Q&As also specify that if Federal costs under a Section 1115 demonstration could exceed what is permitted under the demonstration’s budget neutrality agreement, the state may use procedures specified in the special terms and conditions to change its program to maintain budget neutrality, without violating the MOE requirements.