New York State Medicaid Submits Concept Paper for a New 1115 Waiver Demonstration

The New York State Department of Health today submitted a new Medicaid demonstration proposal and concept paper to the Centers for Medicare & Medicaid Services (CMS) designed to address the link between health disparities and systemic health care delivery issues that have been highlighted by the COVID-19 Pandemic.

Under this proposal, the State will request $17 billion in new Medicaid funding over five years as part of a new 1115 Waiver Demonstration. This concept paper is a first step in the development and negotiation of the next 1115 Waiver request intended to serve as the most effective successor to Delivery System Reform Incentive Payment (DSRIP) in achieving sustainable delivery system reform, with a focus on reducing health disparities and promoting health equity. If approved, this 1115 Waiver Demonstration would utilize an array of multi-faceted and linked initiatives in order to change the way the Medicaid program integrates and pays for social care and health care in New York. It would also lay the groundwork for reducing long standing racial, disability-related and socioeconomic health disparities, increase health equity through measurable improvement of clinical quality and outcomes, and keep overall Medicaid program expenditures budget neutral to the federal government.

To achieve this overall goal of fully integrating social care and health care into the fabric of the NYS Medicaid program, while recognizing the complexity of addressing varying levels of social care needs impacting the Medicaid population, this waiver proposal is structured around four goals:


  1. Building a more resilient, flexible and integrated delivery system that reduces racial disparities, promotes health equity, and supports the delivery of social care;
  2. Developing supportive housing and alternatives to institutions for the long-term care population;
  3. Redesigning and strengthening health and behavioral health system capabilities to provide optimal response to future pandemics and natural disasters; and
  4. Creating statewide digital health and telehealth infrastructure


To read New York State’s conceptual framework of this new 1115 Waiver Demonstration submitted to CMS please find it posted on Department of Health’s website here: