Final Amendment Request Cover Letter

• Letter also available in Portable Document Format (PDF)

May 6, 2025

Jacey Cooper, Director State Demonstrations Group
Centers for Medicare and Medicaid Services
7500 Security Blvd., Mail Stop S2-25-26
Baltimore, MD 21244-1850

Dear Director Cooper:

Pursuant to the terms of the New York State Medicaid Section 1115 Demonstration Medicaid Redesign Team (MRT) Waiver (11-W-00114/2), New York State (NYS or the State) is pleased to submit the enclosed waiver amendment proposal to the Centers for Medicare and Medicaid Services (CMS) for its approval.

New York is requesting approval from CMS for an amendment to its MRT 1115 Demonstration to implement a new demonstration program for its Medicaid Buy-In Program for Working People with Disabilities (MBI-WPD). The amendment would authorize an 1115 demonstration program that will become the State's new MBI-WPD program to help more working individuals with disabilities qualify for Medicaid, with the goal of helping to ensure that these individuals are able to pursue employment opportunities without fear of losing or not qualifying for Medicaid coverage.

With this amendment, the State is also requesting a change to the Special Terms and Conditions (STC) language governing the maximum number of allowable days for backfill payments in the Career Pathways Training (CPT) Program. The State is requesting an increase from the current limit of two days per week to up to five days per week to accommodate more intensive training programs.

New York has fully complied with federal transparency requirements in preparation for formally submitting this waiver amendment proposal. The State transmitted tribal and public notices referencing the preliminary proposal draft (November 6, 2024), conducted virtual public hearings (November 25, 2024, and December 4, 2024), and received a total of 35 written and verbal comments. The State's engagement with stakeholders informed the structure and substance of this submission and have been addressed in the attached waiver amendment application.

The partnership between CMS and NYS continues to be important to the success of the underlying 1115 Demonstration MRT Waiver and will also be critical to this amendment's success. We look forward to continuing to work with you and your colleagues. If you have any questions, please contact me.

Sincerely,

Amir Bassiri
Medicaid Director
Office of Health Insurance Programs

cc: Jonathan Morancy, CMS
      Nicole McKnight, CMS
      Francis McCullough, CMS
      Juliana Sharp, CMS
      Melvina Harrison, CMS
      Selena Hajiani, NYS DOH
      Simone Milos, NYS DOH
      Gabrielle Armenia, NYS DOH
      Annemarie Massaro, NYS DOH
      Mary Frances Carr, NYS DOH