DOH Accepting Comments on Amended MRT Waiver and Strategies Until Jan. 15

As noted in the Dec. 23 issue of Intelligence, the State Department of Health (DOH) has released revised plans for its $10 billion MRT waiver amendment.  DOH is accepting comments on the new proposal until Jan. 15.  LeadingAge New York is analyzing the plan and encourages member input, ideally by Jan. 13, as we prepare a response.

The waiver proposal would allow the state to reinvest $10 billion in MRT-generated federal savings into the health care delivery system over a period of five years.  DOH proposed a variety of strategies in the initial waiver amendment proposed in 2012; however CMS deemed some of the proposals “unfundable,” including investments in health information technology, rental subsidies and capital. 

In the modified request to the Centers for Medicare and Medicaid Services (CMS), the state seeks to accommodate CMS's concerns, while achieving the intended aims of the waiver, through three different vehicles:

• The Delivery System Reform Incentive Payment (DSRIP) Program:  This program will provide $7.375 billion in performance-based payments over five years to public hospitals and “safety net” providers for reducing avoidable hospitalizations;
• A Medicaid State Plan Amendment (SPA):  This amendment will be used to fund $525 million over five years in health home development grants; and,
• Managed Care Contract Payments:  These payments pass through managed care plans to support primary care technical and operational assistance; health workforce needs such as retraining, recruitment and retention; and 1915i home and community-based services for individuals with serious mental illness and/or substance use disorders.

DOH information regarding the waiver updates, including a full description of the DSRIP and a summary of the SPA and managed care contracting strategies, can be found here.  

DOH has requested that comments on the DSRIP plan and the other waiver documents be sent to MRTwaiver@health.state.ny.us by Jan. 15, 2014. You may submit comments to us or to DOH directly; however we ask that you include us on messages to DOH so we can be sure to include your thoughts in our submission.

Contact: Diane Darbyshire, ddarbyshire@leadingageny.org, 518-867-8828