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CMS Approves Amended New York Section 1115 Waiver

Julie Kozminski
January 11, 2024

The Centers for Medicare & Medicaid Services (CMS) on Jan. 9 approved an amendment to New York’s Section 1115 waiver, “Medicaid Redesign Team,” to advance health equity, reduce health disparities, support health-related social needs (HRSN) services, and promote workforce development.

HRSN Services

Along with funding to support HRSN infrastructure, CMS authorizes more than $3 billion to increase coverage of HRSN services, with additional services available to 10 categories of beneficiaries with higher needs. Further, nutrition interventions will be available to individuals with high-risk pregnancies during the pregnancy and two months postpartum. The state also will cover six months of short-term pre-procedure and post-hospitalization housing.

Workforce

New York will receive $694 million to implement two programs: Student Loan Repayment for Qualified Providers and Career Pathways Training (CPT).

Student loan repayment will be available for psychiatrists, primary care physicians, dentists, nurse practitioners, and pediatric nurse specialists who make a four-year work commitment to a practice panel that includes at least 30 percent Medicaid or uninsured members.

The CPT program will build the allied health care workforce by funding training and education focused on career advancement and unemployed individuals.

Medicaid Hospital Global Budget Initiative

CMS has authorized $2.2 billion for the Medicaid Hospital Global Budget Initiative for private nonprofit hospitals that are financially stressed to invest in delivery system reform and transition to a global budget. Hospital must be located in New York City and have a high Medicaid and uninsured payor mix.

Substance Use Disorder Amendment

CMS also approved an amendment for New York to receive matching funds for beneficiaries with a substance use disorder diagnosis residing in an institution for mental disease.

The state will increase provider rates by at least two percent for each service category in Medicaid managed care and fee-for-services delivery systems and plans to expand Medicaid continuous eligibility to children up to age 6.

Contact Director of Policy Rob Nelb, MPH, at rnelb@essentialhospitals.org or 202.585.0127 with questions.

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