New York State Submits $13.52 Billion Medicaid Ask to CMS
Post Written by Kalin Scott, Chief Innovation Officer
The highly-anticipated 1115 Waiver ask from New York was officially submitted to CMS; now begins CMS review & public comment period.
Big news today for anyone following DSRIP 2.0 in New York: New York Medicaid released its long-awaited $13.52 billion formal waiver amendment request to the Centers for Medicare and Medicaid Services (CMS). Stakeholders in New York have been waiting for this document to drop - the state Medicaid team signaled an early September release, and it’s arrived right on time.
Why is this so important?
This document release is the formal request to CMS for funding to follow up to the state’s successful Delivery System Reform Incentive Payment (DSRIP) program. If you’ve been following previous updates, you’ll remember that a draft version of this document was released in April 2022 for public comment. Today’s release reveals that New York submitted this request to CMS on September 2, formally starting the clock on the waiver amendment process, putting the ball in CMS’s court, and moving from concept development to negotiations.
What’s new in this version? What’s stayed the same?
The cover letter and updated 82-page document reflect public comment from the stakeholder engagement process earlier this year. Stay tuned to this blog for a deeper dive into the program elements and key takeaways later this week.
Notably, the state is still requesting $13.52B - a significant ask of CMS. Many of the program elements from previous versions remain - Health Equity Regional Organizations (HEROs), Social Determinants of Health Networks (SDHNs), and significant funding for Value-Based Payment (VBP) are all included in the updated document.
Where can you learn more?
We’ll release a detailed analysis of the state’s request later this week. In the meantime, check out some of our previous posts to get caught up on where we are today:
April 2022 Overview of $13.52 Waiver Request: a high-level overview and analysis of the state’s draft proposal released earlier this year for public comment
Additional Detail on New York’s DSRIP 2.0 Proposal: Detail on 1115 waiver implementation timelines and likelihood of approval
The Path to NY’s Waiver Ask: DSRIP Success: an overview of the state’s previous DSRIP program and context leading up to its current ask
Blueprint for Change: key takeaways and indicators of success from DSRIP 1.0.
What’s next? How can you share your feedback?
CMS has 15 days to review the state’s application and deem it complete. Once that occurs, a thirty-day federal public comment period begins. You can share your feedback through the CMS webpage for New York’s 1115 Waiver, beginning as soon as September 17.
In addition, the state Medicaid program is holding its annually required 1115 MRT waiver public hearing on September 28, giving an opportunity to anyone who wants to comment - you can be sure that this will be a key focus. Learn more about the state’s public hearing on its 1115 MRT Waiver website.
Finally, stay tuned and watch this space for more updates in the coming days. Questions or reactions? Get in touch, and let me know what you think.
About the Author: Kalin Scott is the Chief Innovation Officer at Helgerson Solutions Group. Follow her on Twitter and connect with her on LinkedIn.
