DSRIP Weekly Update-Sept. 1, 2015

This week, the Department of Health (DOH) issued important updates to their Delivery System Reform Incentive Payment (DSRIP) program Frequently Asked Questions (FAQ) document and Medicaid Matters provides consumer educational resources regarding the upcoming DOH opt-out mailing.

Opt-Out Fact Sheet for Medicaid Beneficiaries

As we previously reported, the State will be sending a mailing to all Medicaid beneficiaries in New York State, providing them to opportunity to take action to opt-out of the information sharing of their health information for the purposes of DSRIP program. We anticipate this mailing will go out this month. A fact sheet for consumers regarding the opt-out letters has been developed by the Medicaid Matters NY DSRIP Workgroup. The fact sheet provides some information about DSRIP and helps the consumer understand their choices. Medicaid Matters has provided the fact sheet in English, Spanish, traditional Chinese, Haitian-Creole, Arabic, Korean, and Russian. We suspect that the fact sheet will be useful as consumers might ask you for help understanding the information, and you are welcome to share the fact sheets broadly.

DSRIP FAQs Updated

The DSRIP FAQs document has been updated and is available here. A summary of the changes is provided at the beginning of the document, and each updated question has a note indicating a revision date of Aug. 28, 2015. LeadingAge New York has highlighted below some of the key items we believe may be of most interest to members. However, DOH has made a significant number of important updates to the FAQs and it may be worthwhile for members to review the documentation in its entirety.

Providers that were not included in a DSRIP Performing Provider System (PPS) can still contact their local PPS for possible participation.
The FAQs discuss the limited circumstances under which a provider can be removed from a PPS, and the process must follow the required governance procedures, including progressive sanction requirements.
A Performing Provider System (PPS) has the autonomy to allocate performance funds how it best sees fit, as long as at least 95% of performance payments go to safety net qualified partners and no more than 5% go to non-qualifying safety net partners. However, the PPS funds allocation must be described in the DSRIP Budget and Flow of Funds section of the Project Plan Application and include a description of how DSRIP performance payments will be distributed amongst providers, and how the distribution of funds is consistent with the governance structure and DSRIP goals. After DSRIP payments are received from the PPS Lead, Partners are not restricted from making payments to other in-network or out-of-network providers (e.g., contracts for DSRIP-supportive services).
Guidance and information is provided on New Governing Structures (“NewCo”)
The role of managed care in DSRIP is discussed.

The FAQs may be revised quarterly (or as needed). Any questions may be directed to dsrip@health.ny.gov.

Upcoming Key Dates

Sept. 8: Independent Assessor provides feedback to PPSs on First Quarterly Report/Implementation Plans
Sept. 15: Additional Regulatory Waiver Requests Due, Open PPS Performance Networks in the Medicaid Analytics Performance Portal (MAPP) for edits and additions
Sept. 17 and 18: PPS Statewide Learning Symposium
Oct. 7: Final Approval of PPS First Quarterly Reports/Implementation Plans
Oct 13: Final PPS First Quarterly Reports/Implementation Plans posted to DSRIP Website

MRT Innovation Exchange News

The MRT Innovation Exchange (MIX) newsletter reported on some highlights from recent online dialogue. Members might be interested in looking at posts related to The Power of Public Transparency, or create new discussions to generate conversations relevant to your organization. Click here to get on the MIX and participate.

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