By Lara Kassel, Coordinator of Medicaid Matters NY
In April, the New York State Department of Health (DOH) submitted a request to the federal government for an influx of funds to New York’s Medicaid program. Technically speaking, it is an application for an amendment to the state’s existing 1115 waiver, an agreement between the State and the Centers for Medicare and Medicaid Services (CMS) that allows the state to pursue innovative initiatives in the program.
Dubbed Strategic Health Equity Reform Payment Arrangements: Making Targeted, Evidence-Based Investments to Address the Health Disparities Exacerbated by the COVID-19 Pandemic, the application is being hailed by DOH as a way to reach greater health equity through a large investment – over $13 billion over five years – in the Medicaid program.
Advocates across the state submitted comments during the open public comment period in May. The Medicaid Matters comments aired coalition members’ concerns and interests related to the State’s intentions, broken up into three categories:
- Lessons learned from the most-recent Medicaid waiver (referred to as the Delivery System Reform Incentive Payment program, or DSRIP);
- Oversight and accountability in Medicaid Managed Care (as the design laid out in the state’s application relies on allocating billions of dollars through managed care plans); and
- Ensuring the state’s overall goal of greater health equity will truly make a difference for people and their health and well-being.
The state will submit a revised version of the application to CMS in September. This will trigger another round of open public comments. The revised version will attempt to respond to the public comments DOH received in May. Medicaid Matters will take a critical look at the revision, with an eye toward how consumer advocate concerns and interests were addressed.
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