- Help Us Keep the Medicaid Promise - Submit Your Proposals by February 21st 12:00pm

If you have any questions on this form, please email mrtupdates@health.ny.gov.
Please provide your contact information:

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* 1. Contact information:

Please provide a descriptive title for your proposal identifying the specific topic being addressed (e.g. Comprehensive fee-for-service pharmacy reform).

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* 3. Proposal Title (Limit to 10 words or less)

How does the proposal align with the MRT II guidelines?
Which best describes your proposal?

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* 7. Which describes your proposal: Check all that apply...

Which of the following NYS Medicaid Redesign goals does your proposal address?

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* 8. Medicaid Redesign Goals: Please check all that apply

Please explain your proposal in the box below. The response should be concise but descriptive. The explanation may be supported by data and may identify the cost of implementing the investment, anticipated savings generated by the proposal, and how quality of care may be improved.

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* 9. Proposal Description: Please limit your description to 350 words or less.