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MRT Waiver Amendment Update

MRT Waiver Amendment

Governor Andrew M. Cuomo announced on April 14, 2014 that New York has finalized terms and conditions with the federal government for a groundbreaking waiver that will allow the state to reinvest $8 billion in federal savings generated by Medicaid Redesign Team (MRT) reforms. The MRT waiver amendment will transform the state's health care system, bend the Medicaid cost curve, and ensure access to quality care for all Medicaid members.

The Medicaid 1115 waiver amendment will enable New York to fully implement the MRT action plan, facilitate innovation, lower health care costs over the long term, and save scores of essential safety net providers from financial ruin. The waiver allows the state to reinvest over a five-year period $8 billion of the $17.1 billion in federal savings generated by MRT reforms.

The waiver amendment dollars will address critical issues throughout the state and allow for comprehensive reform through a Delivery System Reform Incentive Payment (DSRIP) program. The DSRIP program will promote community-level collaborations and focus on system reform, specifically a goal to achieve a 25 percent reduction in avoidable hospital use over five years. Safety net providers will be required to collaborate to implement innovative projects focusing on system transformation, clinical improvement and population health improvement. Single providers will be ineligible to apply. All DSRIP funds will be based on performance linked to achievement of project milestones.

In addition, the special terms and conditions also commit the state to comprehensive payment reform and continuing New York's effort to effectively manage its Medicaid program within the confines of the Medicaid Global Spending Cap.

Governor Cuomo has aggressively advocated for waiver amendment approval over the past 18 months and repeatedly made the case to HHS Secretary Kathleen Sebelius on the state's need for MRT savings reinvestment to transform the health care delivery system. The MRT Waiver Amendment will pave the way to continue the efforts of the MRT in advancing reform and transformation in New York's health care delivery system.

More information on the MRT Waiver Amendment documents and DSRIP program, opportunities to provide public comment, and supplemental materials providing additional information is available at: https://www.health.ny.gov/health_care/medicaid/redesign/delivery_system_reform_incentive_payment_program.htm