CMS Exceptions Approval for Newcos

January 14, 2015

Jason Helgerson
State Medicaid Director and Deputy Commissioner
Office of Health Insurance Programs
New York State Department of Health
Empire State Plaza
Corning Tower (OCP - 1211)
Albany, NY 12237

Dear Mr. Helgerson:

This letter is to inform you that the Centers for Medicare & Medicaid Services (CMS) has made several determinations for granting vital access provider (VAP) exceptions under New York´s delivery system reform incentive payment (DSRlP) program. CMS is making final safety-net provider determinations for provider systems that have applied for a safety net provider designation after creating not-for-profit new corporations.

The following entities are approved to participate in DSRlP as safety net providers and as lead entities in a performing provider system (PPS):

  • Southern Tier Rural Integrated PPS
  • Bronx Lebanon PPS
  • Mount Sinai PPS
  • Central New York DSRlP PPS, Inc.
  • Fingerlakes PPS
  • Ellis Hospital (New Corporation)
  • Advocate Community Providers, Inc.
  • Richmond University Medical Center & Staten Island University (New Corporation)
  • SB Clinical Network IPA, LLC

DSRlP participation as safety net providers for these entities is contingent upon New York´s assurance that the entities, by our agreed upon definition, consist of all safety net providers, and that non-qualifying providers will not be added to the PPS without applying for another exception. New York also assures that none of the above entities will become a source for Inter-Governmental Transfer (IGT) in order to receive funding from the Public Hospital Transformation Fund and will only be awarded with DSRlP project funding from the Safety Net Performance Provider System Transformation Fund.

CMS continues with its review of remaining VAP exceptions that were forwarded by New York for consideration, taking into account the state's recommendations and feedback received from public engagement.

Questions related to New York´s 1115 demonstration should be directed to the project officer, Jessica Woodard. Ms. Woodard can be reached at (410) 786-9249 or Jessica.Woodard@cms.hhs.gov. We look forward to continuing to work with you and your staff on the implementation of New York´s DSRIP.

Sincerely,

Eliot Fishman
Director
Department of Health & Human Services
Centers for Medicare & Medicaid Services
7500 Security Boulevard, Mail Stop 52-01-16
Baltimore, Maryland 21244-1850

Cc: Michael Melendez, Associate Regional Administrator, CMS New York