Medicaid 1115 Waiver Renewal

• New Mexico Turquoise Care 1115 Waiver Renewal Application submitted to the Centers for Medicare & Medicaid Services (CMS)
• CMS’ Completion Letter to New Mexico
• HSD Responses to Public Comments received on the Draft Medicaid 1115 Waiver Renewal Application 

The State of New Mexico (the State) primarily operates its Medicaid and Children’s Health Insurance Program (CHIP) under a federal 1115 demonstration waiver authorized by the US Centers for Medicare & Medicaid Services (CMS). Referred to as Centennial Care since 2014, the demonstration authorizes the comprehensive managed care delivery system, the home and community-based services (HCBS) Community Benefit (CB) program, and several transformative pilot initiatives that serve most of the State’s Medicaid beneficiaries. The current demonstration approved by CMS is referred to as Centennial Care 2.0, which expires on December 31, 2023. Building upon the strong foundation created by Centennial Care, the State will submit a 5-year waiver renewal application to CMS in 2022 for an anticipated effective date of January 1, 2024. Through the demonstration renewal, the State will introduce its new demonstration name: Turquoise Care which will be effective through December 31, 2028.

Stakeholder Engagements

HSD has held several stakeholder engagements to obtain valuable input on the current Centennial Care 2.0 Medicaid program and innovations that can be explored for the future Medicaid program. A formal Public Comment Period, including Tribal Consultation and Public Hearings are forthcoming.

Following is a listing of stakeholder engagements to date:

Following are the presentations conducted during the respective stakeholder engagements:

• Tribal Listening Session
• Stakeholder Session
• Tribal Meetings
• Virtual Tribal Listening Sessions

New Mexico Human Services Department

Draft Medicaid 1115 Demonstration Waiver Renewal Application

Abbreviated Public Notice

The New Mexico Human Services Department’s (HSD’s) current Centennial Care 2.0 waiver (Project Number 11-W-00285/9) will expire on December 31, 2023 and HSD will submit a 5-year Medicaid 1115 demonstration waiver renewal application under the name Turquoise Care to the Centers for Medicare and Medicaid Services (CMS) in 2022 for an anticipated effective date of January 1, 2024 through December 31, 2028, seeking federal approval to renew and enhance the current Centennial Care 2.0 waiver.

This abbreviated public notice provides information regarding the proposed renewal request to CMS.

This renewal seeks to continue authorization for New Mexico’s Medicaid delivery system, continue successful programs, enhance programs where needed, and add several new programs to continue and improve high quality care delivery for Medicaid members in New Mexico.

Renewal materials

• Draft Medicaid 1115 Waiver Renewal Application
• Full Public Notice
• Tribal Notification
• Turquoise Care Vision Document

About the Renewal
HSD is pursuing a five-year renewal of New Mexico’s current Medicaid 1115 waiver demonstration, currently referred to as Centennial Care 2.0, that authorizes much of the State’s Medicaid program. In alignment with the HSD’s overall mission, the State aims to provide high quality, well-coordinated, and person-centered care to members and families through the Medicaid program. Over the next five years, the State seeks to simplify and improve member experience through enhanced benefits and delivery systems, with the ultimate goal of achieving improved health outcomes and well-being for New Mexicans through various outlets:

• 1115 waiver initiatives;
• Addition of new services through State Plan Amendments (SPAs);
• Re-procurement of Managed Care Organizations (MCOs) to enhance and implement the State’s vision and goals; and
• Partnering across State agencies including the Departments of Health, Children Youth and Families, Early Childhood Education and Care, and Aging and Long-Term Services to take meaningful steps towards whole person care, through policy and program coordination, as well as the use of technology to improve experiences for New Mexicans.

In addition to providing critical health coverage and access to care, Turquoise Care’s goals and initiatives center on improving core health outcomes and attending to the social and economic determinants of health, particularly centered on addressing the needs of the State’s historically underserved populations. Our vision is that every New Mexico Medicaid member has high-quality, well-coordinated, person-centered care to achieve their personally defined health and wellness goals.

To move closer to our vision, we propose to operate a data-driven Medicaid program that measures quality based on population health outcomes. To support this vision, the Turquoise Care waiver is constructed around three goals:

• Goal 1: Build a New Mexico health care delivery system where every Medicaid member has a dedicated health care team that is accessible for both preventive and emergency care that supports the whole person – their physical, behavioral, and social drivers of health.

• Goal 2: Strengthen the New Mexico health care delivery system through the expansion and implementation of innovative payment reforms and value-based initiatives.

• Goal 3: Identify groups that have been historically and intentionally disenfranchised and address health disparities through strategic program changes to enable an equitable chance at living healthy lives.

Five populations were selected as target populations given their experiences with societal inequities, disproportionately high demand for health supports and services, and disparities they have experienced within the state of New Mexico. These five populations are:

a. Prenatal, postpartum, and members parenting children, including children in state custody (CISC);
b. Seniors and members with Long Term Services and Supports needs;
c. Members with behavioral health conditions;
d. Native American members; and
e. Justice-involved individuals.

Many of the key waiver and expenditure authorities, and pilot programs have been created to support these populations to ensure they receive equitable care.

The 1115 waiver demonstration authorizes New Mexico’s Medicaid Managed Care delivery system. All current programs within the Centennial Care 2.0 waiver will continue and/or expand under the renewal. These include:

• Continued authorization of New Mexico’s Managed Care delivery system;
• Continued Medicaid coverage and benefits for all current eligibility groups, including expansion of enrollment for children up to age six;
• Expansion of Community Benefit slots for Home and Community-Based Services (HCBS);
• Expanded Centennial Home Visiting Pilot Programs; and
• Expanded Access to Supportive Housing.

In addition, several new programs will be launched under the renewal:

• Medicaid Services for High-Need Justice-Involved Populations 30 Days Before Release;
• Chiropractic Services Pilot; 
• Member-Directed Traditional Healing Benefits for Native Americans (Note: The State has hosted Tribal Listening Sessions to gather feedback on the new Member-Directed Traditional Healing Benefits for Native Americans. The State will continue to engage Tribal leaders while finalizing this proposal);
• Enhanced Services and Supports for Members in Need of Long-Term Care;
• Environmental Modifications Benefit Limit Increase;
• Transitional Services Benefit Limit Increase;
• Two Home-Delivered Meals Pilot Programs;
• Addition of a Closed-Loop Referral System;
• Medical Respite for Members Experiencing Homelessness;
• Graduate Medical Education (GME) funding and technical assistance for new and/or expanded primary care residency programs; and
• Additional support for rural hospitals.

Opportunities to Provide Input
The draft Medicaid 1115 demonstration waiver renewal application is open for public comment from September 6, 2022 to October 31, 2022. Public comment is open to anyone who would like to share feedback. We encourage healthcare and social service providers, Tribal leadership, Indian Health Service, Tribal Nations, Tribal health providers, Urban Indian healthcare providers, Managed Care Organizations, hospitals and health systems, medical associations, community-based organizations, the public, and others to provide input.

All information and materials pertaining to the renewal, including the full public notice, public hearing dates and times, tribal consultation date and time, public comment submission instructions, and a copy of HSD’s full draft demonstration renewal application are available on this webpage.

If you do not have internet access, a copy of the draft waiver application may be requested by contacting HSD’s Medical Assistance Division (MAD) at 505-827-1337. If you are a person with a disability and require this information in an alternative format or require a special accommodation to participate in the public hearing, please contact MAD in Santa Fe at 505-827-1337. The Department requests at least ten (10) calendar days advance notice to provide requested alternative formats and special accommodations.

Share your feedback by:

• Participating in a public hearing webinar. HSD will hold two public hearings to receive comments by teleconference due to the Public Health Emergency (PHE):

September 30, 2022
10:00 a.m. – 12:00 p.m. Mountain Standard Time (MST)
Zoom Webinar Information:
Dial In: 312-626-6799
Meeting ID: 952 6881 1134
Password: 759475
Link: https://mmc.zoom.us/s/95268811134
Instructions for joining Zoom webinar: click the zoom link, select “Join Meeting as an Attendee”, and complete the webinar registration form.
Presentation: Turquoise Care 1115 Renewal Public Hearing

October 7, 2022
10:00 a.m. – 12:00 p.m. MST
Zoom Webinar Information:
Dial In: 312-626-6799
Meeting ID: 914 0081 8765
Password: 197908
Link: https://mmc.zoom.us/s/91400818765
Instructions for joining Zoom webinar: Click the zoom link, select “Join Meeting as an Attendee”, and complete the webinar registration form.
Presentation: Turquoise Care 1115 Renewal Public Hearing

Email: 1115.PublicComments@state.nm.us

• Mail:
  Human Services Department
  ATTN: HSD/MAD 1115 Public Comments
  P.O. Box 2348
  Santa Fe, New Mexico 87504-2348

HSD has also scheduled a virtual government to government Tribal Consultation on October 14, 2022. Tribal Notification is located at https://www.hsd.state.nm.us/providers/written-tribal-notification-letters/. Meeting information for the Tribal Consultation is as follows:

October 14, 2022
10:00 am – 12:00 pm Mountain Standard Time (MST)
Zoom Meeting Information:
Dial In: 312-626-6799
Meeting ID: 924 8429 8381
Password: 304364
Link: https://mmc.zoom.us/s/92484298381
Instructions for joining Zoom webinar: Click the zoom link, select “Join Meeting as an Attendee”, and complete the webinar registration form.
Presentation: Turquoise Care 1115 Renewal Tribal Consultation                  Recording: Tribal Consultation Recording

The deadline to provide public comment is Monday, October 31, 2022 at 5:00 pm MST.