NYAPRS Note: This note came last Friday from the NYS Health Department.
NYS Home and Community Based Service (HCBS) providers (including peer and family support, employment, crisis and clubhouse rehabilitation) will now be eligible to be a full-fledged member of the emerging new DSRIP Performing Provider Systems (PPSs).
DSRIP refers to the federal ‘Delivery System Reform Incentive Payment’ program that requires states to achieve a 25% reduction in avoidable hospital use over the next five years via “innovative projects focusing on system transformation, clinical improvement and population health improvement.” New York’s strategy relies on the establishment of Performer Provider Systems, which are regional networks of hospital and community providers. Most PPSs are focused on fostering behavioral and physical healthcare integration, seeking improvements and reduced costs for those with both serious mental health needs like diabetes, asthma and COPD.
Getting HCBS services designated with full-fledged DSRIP safety net status allows them to play a much more central and better financed role, something that has been a top advocacy goal for NYAPRS.
“New York is pleased to announce that the Centers for Medicare & Medicaid Services (CMS) has finalized their review of the Vital Access Provider (VAP) Exceptions of providers to participate in DSRIP with a safety net designation. These approvals are in addition to the nine approved lead entities announced in January 2015.
The approved entities include:
Ø Three(3) Licensed Home Care Services Agencies (LHCSA):
o Aftercare Nursing Services, Inc.
o Family Services of Westchester, Inc.
o Independent Health Care Services
Ø Harm Reduction Providers
Ø Home and Community Based Services (HCBS) 1915(i) Providers
Ø State Designated Health Homes
o Health Homes are only approved for safety net designation based on state’s criteria of providers that billed $10,000 or more of health home and care management services to Medicaid annually.
The link below contains the CMS approval letter.
(http://www.health.ny.gov/health_care/medicaid/redesign/dsrip_safety_net_definition.htm)
Please note that any provider that was not approved by CMS for safety net designation may still participate in DSRIP under their respective PPS’ as a non-qualified provider. This includes non-qualified health homes within a network that has approved safety net providers. Non-qualified providers, as a group, cannot receive more than 5 percent of the project’s total value.
If questions arise related to the Vital Access Provider Exception or DSRIP safety net process, please send an email to BVAPR@health.ny.gov . All other questions can be directed to DSRIP@health.ny.gov.
Sincerely,
The NYS DSRIP Team