New York State Healthcare Access Loan Repayment (HEALR) Program - Employer Application

This application is for eligible employers who wish to apply for the New York State HEALR Program, administered by the Office of Health Insurance Programs (OHIP), on behalf of their current and/or prospective employees. Submission Limit: Employers may submit applications for a maximum of five (5) employees. In the case of organizations with multiple sites/facilities, this limit applies per site/facility. You must complete one application per employee. If you, as an employer, wish to have more than five employees considered for the HEALR Program, please direct additional interested employees to complete the individual application, located here.

The HEALR Program will provide student loan repayment assistance to providers in the eligible roles, listed below, who make a four-year commitment to maintain a personal practice panel or work at an organization where at least 30% of the patient panel are Medicaid members and/or uninsured individuals, or that is contracted with a state-designated Social Care Network (SCN) and providing Health Related Social Needs (HRSN) screening, referrals, and/or services. 

Eligible roles and award amounts are as follows: 

• Psychiatrists - Up to $300,000 per awardee
• Primary Care Physicians - Up to $100,000 per awardee
• Dentists - Up to $100,000 per awardee
• Nurse Practitioners - Up to $50,000 per awardee
• Pediatric Clinical Nurse Specialists - Up to $50,000 per awardee

Program guidelines are available on the NY HEALR Program website.  

 

To be an eligible employer you must meet the criteria below and have an approved attestation form submission for the HEALR or Career Pathways Training programs. Prior to starting the application, please verify that your organization is listed on the 1115 Workforce Initiatives Service Commitment Sites website. If your organization is not listed, please have an appropriate representative from your organization fill out the attestation form in accordance with the process outlined below.

Eligibility Criteria: 

An eligible service commitment site, defined as an organization, facility, or practice:

• where at least 30% of the patient panel are Medicaid members and/or uninsured individuals; OR
• that is contracted with a state-designated SCN and providing HRSN screening, referrals, and/or services.

Process for Attestation Form Submission:

Approval is granted at the individual site level. Health systems must submit a separate attestation for each of its locations.

1. Verify Facility Listing: Visit the 1115 Workforce Initiatives Service Commitment Site directory to confirm if your facility is already approved. 

If your facility is not listed: 

2. Check Eligibility: Facilities not found in the listing must first confirm they satisfy one or more of the eligibility criteria. Note: Applications submitted by employers prior to form verification of eligibility and approval by the Office of Health Insurance Programs (OHIP) will not be processed until eligibility is verified.

3. Download the Form: Download the 1115 Workforce Initiatives Service Commitment Site attestation form.

4. Complete and Submit: Request that an authorized representative from your organization complete the form and submit it to HEALR@health.ny.gov.

5. Review and Notification of Outcome: The Office of Health Insurance Programs (OHIP) will review your submission and determine your facility's eligibility.

a. OHIP will send the result of their review to the email address used for submission. If you are not the party submitting the application and would like to be directly notified of eligibility decision, please ensure that you are cc'd on the attestation submission email. 

b. If approved, your facility will be added to the eligible list and may immediately submit up to five employee applications. You may submit applications upon receipt of eligibility verification and do not need to wait for your facility to appear on the public list.

 

If you have questions prior to or while completing this application, please contact HEALR@health.ny.gov.

Prior to starting the application, please verify that your organization is listed as an eligible organization on the 1115 Workforce Initiatives Service Commitment Sites website. If your organization is not listed, please have an appropriate representative from your organization fill out the attestation form. An employer must be approved as eligible service commitment site prior to submitting applications on behalf of staff.  

It is important to note that this employer application is only part of the full HEALR Program application. Once you submit the employer application on behalf of the current and/or prospective employee, the employee will receive an email with a link to the full application that will be prefilled with the responses from your submission. The employee is responsible for verifying/editing all pre-filled responses, completing all additional application fields, and submitting the full application. If you or the employee have any questions about this process, please contact HEALR@health.ny.gov.

This employer application will take approximately 20 minutes to complete; it is not required that you complete it in one session. If you would like to save your progress and complete your application at another time, please scroll to the bottom of the page and click the save button. You will be directed to set up a Jotform account. After account setup, you will receive an email with a link to resume your application. 

All required fields are marked with an asterisk.

Please answer all the required questions below and have the following employee information at hand to complete the employer application: 

• Employee's Social Security Number (last four digits)
• Employee's Relevant Qualifying Degree Information (relevant degree, institutions attended, and graduation date)
• Employer Medicaid Management Information System (MMIS) Number (if applicable)
• Employer Organization Federal Tax ID/Employer Identification Number (EIN)
• Employee's Supervisor Contact Information (if applicable)

All applications will go through a competitive review process based on federal and state requirements according to the 1115 Waiver Special Terms and Conditions (STCs) that govern the HEALR program. Applications will be evaluated based on factors such as New York State residency, provider type, and dedication to providing services to underserved communities and areas with health provider shortages.

The employee's completed application for the HEALR Program is due by 11:59 PM on January 31, 2026.

As the employer (or employer's representative), you are submitting part of the HEALR Program application to support the employee. For documentation purposes, please provide your name, job title, email, and phone number below. 

Please provide the employee's contact information. The employee will serve as the primary point of contact for this application and will receive all notifications regarding the award decision.

Please provide the information below to confirm the employee's eligibility for the HEALR Program.

 

Please note that applicants who are not currently licensed to practice in New York State are still eligible to apply for the program. However, the employee must obtain New York State Professional Licensure prior to execution of the awardee contract, estimated for late spring 2026.

Please note that if you choose N/A for the question below, the employee is still eligible to apply for the HEALR program. However, the employee's New York State Professional Licensure must be obtained AND in good standing prior to execution of the awardee contract, estimated for late spring 2026. 

To complete this section, specify the details of the employee's qualifying degree, i.e. the highest degree earned related to the healthcare profession indicated on the previous page. For example, if the employee is a Doctor of Medicine (MD), provide the institution(s) attended for their MD degree along with the corresponding graduation date. You need only provide information related to the qualifying degree.

To complete this section, specify the details of your organization to confirm the employee's eligibility.

To be eligible, the employee must make a four-year commitment to: 

• Work at an approved eligible service commitment site, defined as an organization, facility, or practice: 
  • where at least 30% of the patient panel are Medicaid members and/or uninsured individuals; OR
  • that is contracted with a state-designated SCN and providing HRSN screening, referrals, and/or services.

A list of approved eligible organizations can be found on the 1115 Workforce Initiatives Service Commitment Sites website.

After completing the application, but prior to submission, we recommend that you save a copy of the application for your records. To do this, select "Print Form" below and save the file as a pdf to store in your records.