ABBREVIATED PUBLIC NOTICE

Department of Health
MRT 1115 Waiver Extension Request

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

In compliance with 42 CFR 431.408(a)(2)(ii) as well as the current MRT Waiver Special Terms and Conditions regarding the annual Public Forum requirement, the Department of Health is pleased to announce that it will conduct two virtual public hearings/public forums, to provide an overview of the State´s 1115 waiver extension request and allow members of the public to provide comments. This notice further serves to open the 30- day public comment period which will close on Friday, January 15, 2021. In addition to this 30-day comment period where the public will be afforded the opportunity to provide written comments, the Department of Health will be hosting two virtual public hearings during which the public may provide oral comments. Any updates related to the public hearings and forum will be sent via the MRT ListServ.

The New York State Department of Health ("NYSDOH") is requesting a three-year extension of the existing Section 1115 Medicaid Redesign Team ("MRT") waiver demonstration, which is set to expire on March 31, 2021. This extension proposal seeks an extension of all current programs and authorities in the State´s current waiver demonstration, with the following two programmatic amendments:

  • Carveout of the Non-Emergency Medical Transportation (NEMT) Benefit for Managed Long-Term Care Members to Fee-For-Service: The goals of this amendment request are as follows:
    • Improve administrative simplification by creating a consistently managed transportation benefit and removing the benefit from the MRT Waiver;
    • Reduce cost-risk by shifting the broker arrangement to a risk-based arrangement; and
    • Create a larger pool of members by combining all members, except PACE for which the transportation benefit must be managed by the PACE Organization under federal rules, for brokers to provide NEMT service to.
  • Carveout of Pharmacy Benefits from Medicaid Managed Care to Fee-For-Service. The goals of this amendment request are as follows:
    • Provide the State with full visibility into prescription drug costs;
    • Centralize and leverage negotiation power;
    • Provide a single drug formulary with standardized utilization management protocols; and
    • Address the growth of the 340B program and associated reductions in State rebate revenue.

These amendments were developed by the State´s Medicaid Redesign Team II (MRT II), and are part of a larger, more comprehensive set of reforms that the State is planning to innovate and improve the Medicaid program. MRT II brought together a comprehensive set of stakeholders to collectively find solutions that improve the delivery of care and outcomes for Medicaid members and contain spending growth in the Medicaid program.

The two virtual public hearing/public forum meetings will be held as follows:

  1. First Public Hearing/Public Forum
    1. Thursday, January 21, 2021 from 1-4pm.
    2. Pre-registration is required for anyone wishing to provide oral comment using this link.
    3. Individuals who wish to provide comment will need to register with an "SP" in front of their name (ex: SP Jane Doe) and must email 1115waivers@health.ny.gov no later than Wednesday, January 20, 2021 at 4pm to confirm registration.
    4. Individuals will speak in their order of registration. We kindly request that all comments be limited to five minutes per presenter to ensure that all public comments may be heard.
  2. Second Public Hearing/Public Forum
    1. Wednesday, January 27, 2021 from 1-4pm.
    2. Pre-registration is required for anyone wishing to provide oral comment using this link.
    3. Individuals who wish to provide comment will need to register with an "SP" in front of their name (ex: SP Jane Doe) and must email 1115waivers@health.ny.gov no later than Tuesday, January 26, 2021 at 4pm to confirm registration.
    4. Individuals will speak in their order of registration. We kindly request that all comments be limited to five minutes per presenter to ensure that all public comments may be heard.

A draft of the proposed MRT Waiver extension request available for review here. Due to COVID-19 pandemic, the Department of Health offices are operating at a reduced in-person capacity. For individuals with limited online access and require special accommodation to access paper copies, please call (518) 473-0919. While the State will be accepting physical written comments due to COVID-19, comments submitted electronically by email is preferred.

Prior to finalizing the proposed MRT Waiver extension application, the Department of Health will consider all written and verbal comments received. These comments will be summarized and addressed in the final version that is submitted to CMS. The Department will post a transcript of the public hearings, as well as any submitted written public comments, on the following website.

Please direct all questions to 1115waivers@health.ny.gov.

Written comments will be accepted by email at 1115waivers@health.ny.gov or by mail at:

Department of Health
Office of Health Insurance Programs
Waiver Management Unit
99 Washington Ave.
7th fl. (Suite 720)
Albany, NY 12210
All comments must be postmarked or emailed by 30 days of the date of this notice.