Previously Released Information

VAP Exception Appeal Process

The Vital Access Provider (VAP) Exception appeal process ended on October 24, 2014 for all Medicaid providers, physicians and pharmacies or facilities that did not qualify by the Safety Net Definition by calculation or by appeal. If the exception was granted, then the applicant would be qualified to participate in the DSRIP program. Non-qualifying facilities are limited; they may only receive up to 5% (as a group) of their PPS's award. This appeal process was used for any provider type that is not currently considered a safety net provider and intends to be a lead for the DSRIP Project Plan application. (See Safety Net Definition)

The following VAP Exception appeals were provided for a 30 day public comment period ending on December 3, 2014. Approval of these exception appeals was contingent upon obtaining approval from the federal Centers for Medicare and Medicaid Services (CMS).

Comments were submitted electronically to bvapr@health.ny.gov.

Public comments can be found here

The links below contain the February 24, 2015 CMS approval letter and summary of their determination of the Vital Access Provider (VAP) Safety-Net Exception recommendations submitted for inclusion in the DSRIP safety net process:

Forms and Instructions

VAP Exception Appeal Forms and Instructions

Safety Net Appeal Forms

DSRIP VAP Exception forms were due by October 24, 2014. Late appeals were not accepted. If you are already included on an approved safety net list, there is no need to apply for more than one list type unless your identifier (opcert, license, agency code, etc) does not include other services that you wish to be included.

Please note that the Department created two VAP Exception forms expressly for the HCBS/1915i service providers and the State designated Health Homes and Downstream Care Management Agencies. The Health Home and Downstream exception form is for Health Homes and Downstream providers. The use of this form implies that you are using the third exception category: Any state-designated health home or group of health homes.

The HCBS-1915i provider exception form is for pending 1915i OMH, OASAS and Harm Reduction Providers. The use of this form implies that you are using the first exception category: A community will not be served without granting the exception because no other eligible provider is willing or capable of serving the community.

Safety Net Determinations