On January 9th, the Centers for Medicare and Medicaid Services (CMS) approved a new amendment to New York’s Medicaid Redesign Team (MRT) 1115 Demonstration Waiver. New York State (NYS) originally requested an amendment under the name “New York Health Equity Reform” in September 2022.
The new amendment will run during the 3.25-year period from January 2024 through March 2027, when New York will need to pursue an extension of the waiver. It includesfour initiatives with a total of up to $6.69 billion in federal funding:
- Health-Related Social Needs (HRSN): Up to $3.673 billion for building HRSN infrastructure, including the creation of new Social Care Networks (SCNs), and reimbursing for an array of HRSN services through the Medicaid program.
- Health Equity Regional Organization (HERO): Up to $125 million for the creation of a statewide HERO to conduct regional health and HRSN data collection and analysis and, based on this, make recommendations on incorporating HRSN into value-based payment (VBP) arrangements in the future.
- Medicaid Hospital Global Budgets: Up to $2.2 billion to support certain safety net hospitals in Brooklyn, the Bronx, Queens, and Westchester County to transition their Medicaid reimbursement to hospital global budget models, in line with CMS’s new AHEAD model.
- Strengthen the Workforce: Up to $694 million for workforce recruitment and retention efforts, including student loan repayment and training and education programs for individuals who make commitments to serve high-needs populations. Training and education will be funded through Workforce Investment Organizations (WIOs), which will recruit participants and provide ongoing support.
SPG’s summary of the provisions of the waiver is available here. The full text of the waiver approval letter and Special Terms and Conditions (STCs) is available here.