On November 27th, the New York State Department of Health (DOH) formally submitted a waiver amendment request to the Centers for Medicaid and Medicare Services (CMS) for the 1115 Medicaid Redesign Team (MRT) Waiver. The amendment would extend and renew the Delivery System Reform Incentive Payment (DSRIP) program for a total of four years. DSRIP Year 5 is currently scheduled to end on March 31, 2020. In the amendment request, DOH proposes a new federal investment of $8 billion over a four-year time period, consisting of a one-year extension through March 2021 followed by a three-year renewal period through March 2024.
The formal amendment request to CMS follows a public comment period on the initial draft proposal, which was released in September 2019. While the total funding request and amount for each program remains the same, the distribution of funds over time has changed significantly. The submitted proposal now requests only the rollover of existing federal funding during the one-year extension period ($625 million), with the balance of the request ($7.375 billion) to come in the renewal period. Additionally, the Value Driving Entities from the draft proposal have been renamed Value Management Organizations (VMOs), and the submitted request contains significantly more details on the program design of VMOs and the new Social Determinants of Health Networks (SDHNs), including:
- Funding mechanisms;
- Governance requirements;
- Organizational structures; and
- Performance measurement.
SPG has summarized key provisions of the waiver renewal and extension request in the attached document. The formal 1115 Waiver Amendment Request is available here.