Further Information Available on DSRIP and MRT Waiver

Additional resources are now available providing further details on the State’s $8 billion Medicaid waiver agreement with the Centers for Medicare and Medicaid Services (CMS). LeadingAge New York’s legislative and legal counsel, Hinman Straub, has prepared “MRT Waiver Amendment and Delivery System Reform Incentive Payment (“DSRIP”) Program,” a thorough analysis of the program.

The initial DSRIP timeframes have been extended, and the program has been modified significantly from prior versions. DSRIP planning grant funding will now be made available to potential applicants, with non-binding letters of interest due to DOH by May 15th and planning grant applications due June 17th. The actual DSRIP application submission date has been moved to December 2014, and DSRIP project funds are expected to be distributed beginning in April 2015.

The DSRIP program is intended to promote community-level collaborations and focus on system reform, with a specific goal to reduce avoidable hospital use by 25 percent over five years. Safety net providers will be required to collaborate to implement innovative projects focusing on system transformation, clinical improvement and population health improvement.

DOH has created a DSRIP web page which includes several informational and administrative materials related to the program, including the:

• Special Terms and Conditions, which outline how the MRT Waiver Amendment programs are to be implemented, authorized funding sources and uses, and other requirements governing the agreement;  
• Program Funding and Mechanics Protocol, which describes the state and CMS process for reviewing DSRIP project plans, incentive payment methodologies, reporting requirements, and penalties for missed milestones;
• Strategies and Metrics Menu, which describes strategies and metrics available to Performing Provider Systems for including in their DSRIP Project Plan;
• Safety Net Definition, which defines eligible safety net providers and includes actual listings of qualifying nursing homes and home health agencies;
• Presentation and recorded webinar, which provides an overview of the MRT waiver amendment and the state’s DSRIP program; and,
• DSRIP Data Workbooks, which provide Medicaid utilization and performance data intended to assist DSRIP applicants in preparing their grant applications. DOH indicates that more interactive data in dashboard format will be available in June.

As required by CMS, DOH is seeking input from stakeholders on the MRT Waiver Amendment and DSRIP Program. So far, four public hearings have been held, with one more scheduled for April 23 in Buffalo. DOH is also soliciting public comment on the MRT waiver amendment through the MRT website and upcoming webinars to take place over the next several weeks. LeadingAge NY is reviewing all of the waiver documents, and plans to submit written comments on the waiver. Members with feedback are encouraged to contact us.   

Under the agreement with CMS, the $8 billion MRT waiver funds are to be allocated as follows: (1) $6.42 billion for DSRIP planning grants, provider incentive payments, and administrative costs; (2) $500 Million for the Interim Access Assurance Fund – temporary, time limited funding to ensure Medicaid safety net providers can fully participate in the DSRIP transformation without disruption; and (3) $1.08 Billion for other Medicaid redesign purposes including supporting Health Home development and investing in long term care, workforce and enhanced behavioral health services.

LeadingAge New York will keep you updated as we learn more and continue to analyze the waiver documents. In the meantime, do not hesitate to contact us if you have any questions.

Contact: Dan Heim, dheim@leadingageny.org, 518-867-8866