CMS Announces It Will Not Approve New and Additional FMAP Funds for Designated State Health Programs and State Investment Programs
(April 15, 2025) Last week, the Centers for Medicare and Medicaid Services (CMS) announced that it “does not intend to approve new or extend existing requests for federal matching funds for state expenditures on two types of programs — designated state health programs (DSHP) and designated state investment programs (DSIP).”
The State uses DSHPs to leverage funding under its Medicaid 1115 Waivers, including the newest NY Health Equity Reform (NYHER) waiver approved last year. The federal match (or Federal Medical Assistance Percentage (FMAP)) generated by DSHPs can only be used for programs specified in the waiver documents. Under NYHER, the DSHP-funded initiatives include the Health Equity Regional Organizations (HEROs), new Health-Related Social Needs (HRSN) services and infrastructure, and workforce initiatives.
According to LeadingAge NY's attorneys at Hinman Straub, the FMAP funding appears to be approved for the duration of the waiver. However, CMS has authority to review the sources of the non-federal share of funding for the existing waiver.
For NY, DSHP programs of interest to LeadingAge NY members include:
- Vital Access Provider Assurance Program (VAPAP) ($2 billion)
- Expanded In-Home Services for the Elderly Program (EISEP) ($240 million)
- Community Services for the Elderly Program (CSE) ($122 million)
- Managed Long Term Care (MLTC) Ombudsman ($16 million)
- NY Connects ($105 million)
- Supportive Housing ($197 million)
- Caregiver Flexibility Training ($28 million)
The complete list of programs can be found in this letter. The above funds reflect the federal match generated by CMS. These dollar amounts do not reflect the State funds allotted to the listed programs.
LeadingAge NY will monitor this change in direction by CMS and update members as it obtains additional information.
Contact: Meg Everett, meverett@leadingageny.org, 518-867-8871