Federal-State Health Reform Partnership Revised STCs - January 2014


NUMBER:        11-W-00234/2

TITLE:              Federal-State Health Reform Partnership Medicaid Section 1115 Demonstration

AWARDEE:      New York State Department of Health

All requirements of the Medicaid program expressed in law, regulation, and policy statement, not expressly waived in this list, shall apply to the demonstration January 1, 2014 through March 31, 2014.

The following waivers of State plan requirements shall enable New York to implement the approved Special Terms and Conditions (STCs) for the New York Federal-State Health Reform Partnership Medicaid Section 1115 demonstration.

1. Statewideness                  Section 1902(a)(1)

  • To permit the exclusion of some residents of some counties in New York from participation in Mandatory Mainstream Managed Care (MMMC) and Managed Long Term Care (MLTC) under this Demonstration.

2. Income Comparability      Section 1902(a)(17)

  • To enable New York to apply a more liberal income standard for individuals who are deinstitutionalized and receive community-based long term care services through the managed long term care program than for other individuals receiving community-based long term care.

3. Freedom of Choice            Section 1902(a)(23)(A)

  • To enable New York to restrict freedom-of-choice of provider for MMMC and MLTC enrollees, to the extent of the services furnished through those programs. Beneficiaries shall retain freedom of choice of family planning providers.

Demonstration Approval Period: January 1, 2014 through March 31, 2014