CMS Letter

  • CMS Letter also available in portable document format (PDF, 281KB)

December 9, 2015

Deborah Steinbach Project Officer
Division of State Demonstrations and Waivers
Centers for Medicaid, CHIP and Survey & Certification, CMS
MS S2-01-16, 7500 Security Blvd.
Baltimore, Maryland 21244-1850

Dear Ms. Steinbach:

New York State is seeking approval from the Centers for Medicare and Medicaid Services (CMS) to allow for revisions to New York´s Medicaid Section 1115 Demonstration (Project Number 11-W-00114/2), also known as the Partnership Plan. These revisions relate to the section of the waiver titled the MRT Waiver Amendment. The MRT Waiver Amendment was approved in April 2014 , and reinvests $8 billion in savings generated by the Medicaid Redesign Team (MRT) reforms to transform the state´s health care delivery system , bend the Medicaid cost curve, and assure access to quality care for Medicaid members. The proposed revisions will not change the structure or intent of the waiver amendment programs; the revisions are intended to provide clarity, add detail and better reflect the program and policy implementation to date. In addition, the revisions will provide additional detail and reflect actual spending of waiver amendment dollars to date and revised projections of sources and uses in future years.

As outlined in the Special Terms and Conditions (STCs), requests to amend the demonstration must be submitted to CMS for approval no later than 120 days prior to the planned date of implementation of the change and may not be implemented until approved. Tribal notice was issued on November 3, 2015 and public notice was published on December 9, 2015.

Waiver amendments must also address waiver budget neutrality and evaluation design.

A budget neutrality data analysis is attached to this letter. As you know, the Department of Health is currently working with CMS to make updates and modifications to the Budget Neutrality specifications manual. However, the proposed STC changes do not impact overall rates, program totals, or populations, so the figures in this file should align with expected budget neutrality calculations. The evaluation design will not be modified because the proposed amendment will not impact the current plan in discussion between New York and CMS.

I look forward to working with you on these revisions. If you have any questions, please do not hesitate to contact Kalin Scott from my staff at 518-474-3018.


Jason A. Helgerson
Medicaid Director
Office of Health Insurance Programs


cc: Eliot Fishman, CMS
Mike Melendez, CMS
John Guhl, CMS
Ricardo Halligan, CMS
Kalin Scott, NYS DOH