CMS Approves New York 1115 Medicaid Redesign Waiver - McDermott+Consulting

CMS Approves New York 1115 Medicaid Redesign Waiver

On January 9, 2024, the Centers for Medicare and Medicaid Services (CMS) approved the New York State (NY) 1115 Medicaid waiver “Medicaid Redesign Team” (MRT). The MRT is a long-standing waiver in NY that has continuously evolved to improve the administration, structure and financing of the NY Medicaid program; enhance Medicaid beneficiaries’ access to services; and improve health outcomes across the state. The recently approved waiver represents the next step in Medicaid redesign in NY and builds on the previous Delivery System Reform Incentive Payment (DSRIP) program.

As proposed, the MRT aims to advance health equity, reduce health disparities, support the delivery of health-related social needs (HRSN) services and promote workforce development. It will be effective through March 31, 2027.

The MRT is designed to set the stage for NY participation in a new Center for Medicare and Medicaid Innovation (CMMI) model: the States Advancing All-Payer Health Equity Approaches and Development (AHEAD) model.

This article reviews the major initiatives included in the MRT, components of the MRT that were excluded from the approval, next steps for the AHEAD and Making Care Primary models and implications for stakeholders.

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For more information, please contact Katie Waldo, Dale C. Van Demark (McDermott Will & Emery – Partner), Kayla Holgash or Benjamin Glass (McDermott Will & Emery – Associate).