CMS Approves ‘Groundbreaking’ Behavioral Health Integration Waiver for New York

The Centers for Medicare and Medicaid Services (CMS) has approved a $7.5 billion waiver for New York, allowing the state to integrate primary, behavioral health, and health-related social services over the next three years.

One of the main goals of the waiver is to help boost population health and equity outcomes for high-risk Medicaid enrollees, including children, post-partum patients and people with disabilities.

In addition to boosting behavioral health integration, the waiver will also focus on new programs to help address health-related social needs. The waiver also focuses on increasing the number of Medicaid providers in the state.

If the state’s Medicaid-to-Medicare provider rate ratio goes below 80% in behavioral health, primary care, or obstetrics care, the state will be required to increase and sustain Medicaid-fee-for-service provider base rates and Medicaid managed care payments.