NYS Submits 1115 Waiver Proposal to CMS

September 7, 2022

New York State has submitted a Section 1115 Demonstration Medicaid Redesign Team (MRT) Waiver to the Centers for Medicare and Medicaid Services (CMS) for its approval.

With a little help from Josh Rubin at HMA, and a caveat that we have yet to do a thorough review of the final NYS 1115 waiver proposal, there appear to be significant changes to the final waiver proposal that (based on our comments submitted earlier this year – attached) have our fingerprints on them!

Here’s what we see:

  • People with lived experience of the behavioral healthcare delivery system, in HERO governance positions
  • NYS taking the data sharing role away from plans and sharing the data themselves (THIS SHOULD PLEASE BHCC/IPAs)
  • We asked that the statewide referral network be provided by local nonprofits. The state chose SHIN-NY. (Note: We did not request it be SHIN-NY specifically – we just made a general request)
  • Expansion of the populations eligible for pre-release Medicaid services
    Specific attention to VBP arrangements for people with significant BH needs
  • Workforce funding for the BH sector and recruitment/retention bonuses

Those are the ones that jump out at us. Stand by for more analysis.

Here’s a link to an article from Helgerson Solutions, discussing the submitted NYS 1115 waiver proposal: 

The cover letter for the submission is linked here.

Additional details about the waiver request are available here.

NYS Council formal comments we submitted during the comment period in May 2022 are available here.