New York's $1.1 Billion Medicaid Eligibility System Shows Enrollment Gaps One Year In
New York's Department of Health began transitioning more than 147,000 Medicaid and Medicare Savings Program enrollees to a new case management system in September 2025. The system was built by Deloitte Consulting under a contract that started at $177 million in August 2023 and has grown to $1.18 billion through four amendments. State officials say only about one-third of enrollees have been able to automatically renew their coverage without assistance since the transition began.
Single source · Not corroborated
New York State's Department of Health is working to resolve persistent problems in a new Medicaid eligibility and case management system, roughly one year after the first wave of enrollees began migrating to the platform. The system is intended to move Medicaid administration away from local social services departments that rely on paper applications and an outdated legacy system, consolidating enrollment under a single platform run through the state's public health insurance marketplace, New York State of Health.
The Medicaid Eligibility and Client Management system was developed by Deloitte Consulting under a contract that began at $177 million when it was signed in August 2023. The state quietly filed four amendments to the original deal — which expired March 31, 2025 — bringing the total projected cost to $1.18 billion. The largest amendment, at $866 million, extends the contract and includes a work plan modification, according to records in the Open Book New York database.
A second, more complex wave of migration — covering long-term care and nursing home patients — is expected between November 2027 and February 2028. State officials said the contract extension also covers additional testing and compliance work tied to new federal requirements. Health Department spokesperson Cadence Acquaviva said in a statement that the transition "will replace the outdated, expensive, error-prone and inefficient paper-based system with a streamlined, user-friendly platform," and noted that the contract was subject to federal review by the Centers for Medicare and Medicaid Services.