Safety Net Appeal Due and Updated DSRIP Resources

As has been the case the last few weeks, there is a lot of new information regarding the Delivery System Reform Incentive Payment (DSRIP) program. LeadingAge NY is also actively working to develop programming for our members to enhance your understanding of DSRIP. Below is a summary of the week’s happenings and reminders of key dates; we encourage you to let us know what other needs you have.

The Safety Net Appeal application is due June 11 and can be accessed on this page. Despite our advocacy efforts, several provider types were omitted on the list of safety net providers, such as the Assisted Living Program (ALP) and the Adult Day Health Care (ADHC) program. We have recommended that providers who meet the definition of safety net-- that is having 35 percent or more of their patient/consumer volume be those eligible for Medicaid, dual-eligibles (Medicare and Medicaid), or uninsured-- apply for the safety net designation if not specifically designated.

In addition to ALPs and ADHC programs, some other providers, such as home care agencies, have been erroneously omitted for a variety of reasons, including being relatively new services, or possibly providing services under managed care. We urge providers engaging in a DSRIP Performing Provider System (PPS) to check the safety net listing to determine if they need to submit an appeal. The benefit of being a safety net provider for DSRIP purposes is the ability to fully participate financially in the incentive payment.

The Department of Health (DOH) has posted recorded webinars and resources to aid in your understanding of DSRIP. The following calls may be of interest:

DOH is routinely posting new programs and webinars, so be sure to monitor the DSRIP Webinars and Presentations website.

Those of you who are already engaged in conversation with emerging PPSs may be aware that the deadline for DSRIP Design Project Grant Applications has been extended to June 26, 2014. The extension has been granted in recognition that a section of the application related to the Project Advisory Committee (PAC) has been changed. While the lead applicant of the PPS is likely responsible for the grant application, it should be noted that the PAC enables PPS provider participants to help inform the process and may be an opportunity for members. In addition, DOH has issued Questions and Answers, which highlight their desire to have managed long term care plans in DSRIP projects. That being said, MLTCs cannot be designated as safety net providers.

DOH has also announced amendments to sections of the DSRIP document:

Attachment I: 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.
Attachment J: Strategies and Metrics Menu, which describes strategies and metrics available to PPSs for including in their DSRIP Project Plan.

Click here to view the documents, public comments and subsequent amendments.

Lastly, while not an opportunity for members, those engaged in a DSRIP PPS may be interested in DOH’s efforts to procure one contractor to serve as an independent assessor; more information is available on the DSRIP Independent Assessor webpage, as well as a recent Question and Answer document that can be viewed here. In addition, DOH seeks to procure one statewide contractor to act as a Support Team for New York State’s DSRIP program for up to a one-year contract period; more information is available on the DSRIP Support Team webpage.

Members are encouraged to let us know if they have any questions or needs relating to DSRIP.

Contact: Diane Darbyshire, ddarbyshire@leadingageny.org, 518-867-8828