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What is the 1115 Waiver?

The NYS DOH 1115 Waiver is a federal-state partnership that allows New York State to implement a managed care program for Medicaid recipients. The waiver enables New York State to provide comprehensive and coordinated healthcare through managed care organizations, invest in evidence-based programs to address health disparities, and implement innovative initiatives. The waiver has improved access to care, quality of care, reduced costs, and provided flexibility for innovative programs, ultimately benefiting the health of Medicaid recipients in New York State.

NYS- SCN Region Map

What You Need To Know

1115 Waiver at a Glance

SCN Informational Flyer

  • Learn about what the Social Care Network means for CNY & Mohawk Valley

Approved 1115 Waiver

CMS Approved NYS Medicaid Waiver

Approved January 9, 2024

  • View the full CMS Approved 1115 Waiver Ammendment

Letters of Intent

Forward Leading IPA (FLIPA) and Inclusive Alliance IPA are proud to announce a collaboration for the Social Care Network RFA for the CNY region. As the lead entity, FLIPA is developing a SCN that leverages the strength and expertise of stakeholders from multiple sectors that serve the Medicaid population. Experience has taught us that real relationships are necessary to drive coordinated care.

We hope you are willing to be one of our key partners on this important work. To share your support of this application and interest in being a key partner, please provide a letter of intent for this collaborative SCN.

Monthly 1115 Waiver Webinar Series

Each month, on the third Wednesday, Inclusive Alliance hosts a webinar that covers topics around the 1115 waiver. These webinars are open to the public and aim to support all CNY community-based organizations in learning more about service system changes included in the approved 1115 Waiver.

 

 

 

 

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NYS DOH Waiver Page

Information Page

New York State DOH Resources

  • New York State's Medicaid Section 1115 Medicaid Redesign Team Information page

Waiver Definitions

Glossary of terms & definitions

Summary of the CMS NYSHER Waiver Amendment

  • Acronyms, definitions and glossary of terms in the waiver.

Cope Health Solutions

1115 Waiver Overview

Summary of the CMS NYSHER Waiver Amendment

  • Overview and key takeaways presented by national tech firm Cope Health Solutions

Ropes & Gray

1115 Waiver Overview

Summary of the CMS NYSHER Waiver Amendment

  • Overview and key takeaways presented by Ropes & Gray Law Firm

Barclay Damon

1115 Waiver Overview

Summary of the CMS NYSHER Waiver Amendment

  • Overview and key takeaways presented by Barclay Damon Law Firm

HSG Global

1115 Waiver Overview

Summary of the CMS NYSHER Waiver Amendment

  • Overview and key takeaways presented by value based payment consulting firm

Submitted Waiver Proposal

New York Health Equity Reform (NYHER)

Waiver Proposal Submitted September 2, 2022

  • New York StateMedicaid Redesign Team (MRT) Waiver Amendment

Case Study

Six implementation and policy themes

Lessons from North Carolina’s Healthy Opportunities Pilots

  • Addressing Social Needs through Medicaid: Lessons from Planning and Early Implementation of North Carolina’s Healthy Opportunities Pilots

NYS DOH 1115 Medicaid Redesign Team Waiver Webinar

February 2024 updates from NYS DOH on the NYHER and waiver application.

Ready to transform health & Social Care in Our Community?

We're committed to a collaborative, inclusive, and equitable approach to social care across Central New York and Mohawk Valley and we need your support. Get involved today with one of our committees or workgroups.

Medicaid in New York 2023 Conference United Hospital Fund

Medicaid in New York 2023 Conference United Hospital Fund

Slides presented by Amir Bassiri, Medicaid Director, Office of Health Insurance Programs at New York State Department of Health

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  • New York 1115 Medicaid Waiver Information Page
  • Presentation Given July 20, 2023

Conference Summary

Kalin Scott Summary

Summary by Healthcare writer & expert Kalin Scott

  • Summary of the key updates shared by Medicaid Director Amir Bassiri at the United Hospital Fund of New York's annual Medicaid conference.

Conference Summary

Manatt Healthcare Summary

Key Takeaways by Manatt Healthcare Consulting

  • Summary of the key updates shared by Medicaid Director Amir Bassiri at the United Hospital Fund of New York's annual Medicaid conference.

 

1115 Waiver Digest Signup

Inclusive Alliance Event (30)-1
Get the latest news & updates  

Resources for Medicaid Eligibility Reviews

We've put together resources for service providers to help educate and inform the community about the Medicaid renewal process. Anyone in New York covered by Medicaid, Child Health Plus or the Essential Plan any time beginning March 2020 has stayed covered through continuous coverage until March 31, 2023.

Every single person receiving Medicaid will be checked over the next 14 months to make sure they’re still eligible for the program that provides health care for people with low incomes or disabilities.

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