MedicaidCoverageMedium impact
30-Day Public Comment Period Opened for the 1115 Medicaid Redesign Team Waiver Extension Application
NY Medicaid·NY·Provider Bulletin
We identified it
Aug 7, 2026
Summary
New York State is requesting a five-year extension of its Section 1115(a) Medicaid Redesign Team (MRT) demonstration waiver, scheduled to expire March 31, 2027. A 30-day public comment period is open through August 21, 2026, with proposed amendments to workforce initiatives, HRSN services, and elimination of coverage for TANF adults. Billing teams should monitor for potential coverage changes and service discontinuations that may affect NYS Medicaid claims processing.
Action Required
By August 21, 2026: Billing and compliance teams should review the NYS Department of Health 1115 Waiver Extension Request documentation for detailed information on proposed coverage amendments and service changes. Monitor the MRT Listserv (subscribe at NYS Department of Health website) for finalized extension decision and Special Terms and Conditions (STCs) updates. By March 31, 2027: Prepare for potential implementation of amended HRSN services scope and discontinuation of TANF adult coverage if extension is approved. Update billing system configuration, encounter forms, and provider education materials to reflect any coverage changes. Coordinate with compliance and revenue cycle teams to identify affected member populations and adjust authorization workflows accordingly. Failure to implement changes by the effective date of the extension could result in claim denials for discontinued services or ineligible populations.