Dear Colleague Letter Tribal Notification

  • Letter is also available in Portable Document Format (PDF)

September 17, 2019

Dear Colleague:

The New York State Department of Health (NYSDOH) is providing notice of the State´s intent to request approval from the Centers for Medicare and Medicaid Services (CMS) for a four (4) year waiver amendment to further support the quality improvements and cost savings through the Delivery System Reform Incentive Payment (DSRIP) program. As with the original Medicaid Redesign Team (MRT) waiver, New York State seeks a continuation of DSRIP for the 1–year balance of the 1115 waiver ending on March 31, 2021 and conceptual agreement to an additional 3 years from April 2021 to March 31, 2024. Thus, the full four–year extension/renewal period (1–year extension and 3 years of renewal) would span from April 1, 2020 through March 31, 2024.

The New York DSRIP program has already reduced Potentially Preventable Admissions through June 2018 of 21%, well on its way to the goal of 25% by the end of the demonstration. The waiver amendment seeks additional time and funding support for the community collaborations to be sustained and fully mature to successfully transition the DSRIP Promising Practices into Value Based Payment (VBP) arrangements. The State will focus on higher–value practices that are clearly aligned with federal priorities. These federal priority areas include: Substance Use Disorder (SUD) treatment and the Opioid Crisis; Serious Mental Illness and Severe Emotional Disturbance (SMI/SED); Social Determinants of Health; Primary Care Improvement and Value–Driving Payment Models.

In addition, the DSRIP promising practices would expand to certain high–need and high–cost populations, such as higher–risk children and members needing long–term care. A continuation of workforce investments is essential to be responsive in meeting future needs, especially in the long–term care sector, as well as aid to financially distressed hospitals to help accelerate the transformation of acute and ambulatory health care.

The anticipated impact this demonstration would have on Tribal members includes:

  • Improving patient–centered care by further sustaining the integration across physical health, behavioral health, addiction treatment, and social services in communities;
  • Improving access through sustained workforce investments and aid to financially distressed hospitals; and
  • Improving care for higher–risk children and Medicaid members in need of long–term care.

A draft of the amendment proposal is available for review here.

Written comments will be accepted by email at or by mail at the address below. All comments must be postmarked or emailed by November 4, 2019.

NYS Department of Health
Office of Health Insurance Programs
Waiver Management Unit
99 Washington Avenue
12th Floor, Suite 1208
Albany, NY 12210

We look forward to our continued collaboration.


Gregory S. Allen, Director
Division of Program Development & Management
Office of Health Insurance Programs

cc: Sean Hightower
      Vennetta Harrison
      Phil Alotta, NYSDOH
      Michele Hamel, NYSDOH