This comes to us from the NYS DSRIP TEAM.
This announces CMS’ notification to NY that new waiver service providers can be considered for safety net status for purposes of DSRIP. However, if you are already a safety net provider and will become a waiver services provider nothing changes for you – you will continue to be a safety net provider – and you do not have to do anything.
The language in the letter is referring to providers that will become new Mediciad providers by being approved to provide wiaver services for clients of HARPS.
It states that “HCBS 1915(i) providers qualify as safety net providers because their services to Medicaid and uninsured individuals represent more than 35% of their total volume of Medicaid reimbursable services. These providers are approved to be selected by the state as safety net providers upon implementation of programs that allow Medicaid reimbursement of 1915(i) services under the state plan and the 1115 demonstration.”
There will probably be another step where the state actually selects the providers that will be new safety net providers. I assume that all new waiver service providers, once they get set up to bill Mediciad, will be in. We’ll keep you posted.
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:
- Three(3) Licensed Home Care Services Agencies (LHCSA):
- Aftercare Nursing Services, Inc.
- Family Services of Westchester, Inc.
- Independent Health Care Services
- Harm Reduction Providers
- Home and Community Based Services (HCBS) 1915(i) Providers
- State Designated Health Homes
- 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 [email protected] . All other questions can be directed to [email protected].
Sincerely,
The NYS DSRIP Team