Equity Programs (EP) Monthly Update Webinar
- Webinar also available in Portable Document Format (PDF)
January 2017
Today´s Agenda
- EP General Updates
- EP Funding
- EP Contracting
- EP Reporting
- Next Steps and Open Forum
EP General Updates
EP Documents Updates
- The Department of Health (DOH) is scheduled to release the EP Demonstration Year (DY) 3 Guidance Document on Tuesday, February 21st, 2017.
- The guidance document will not introduce any new policies, but rather will just restate the program objectives, participant roles and provide a timeline of important program dates in the upcoming year.
- DOH developed an EIP Guidance Document for Participation in Expanded Health Home (HH) Enrollment.
- The guidance document outlines recommendations for supporting documentation of completion and results the documentation should show for the Participation in Expanded HH Enrollment activity.
- The document is posted on DSRIP’s Supplemental Program’s website https://www.health.ny.gov/health_care/medicaid/redesign/dsrip/vbp_initiatives/supplemental_programs.htm.
EP Funding
EP Funding Update
- The April 2016 rates were effectuated on November 30, 2016.
- With approval of the April 2016 rate package, EIP DY2 adjusted amounts were retroactively paid to the Managed Care Organizations (MCOs) covering April 2016 – December 2016.
- Additionally, MCOs should have received adequate funds to send EPP DY1 performance payments pertaining to April 2016 – December 2016 in accordance with payment schedules in their contracts.
- MCOs will receive monthly payments going forward for the rest of the year (January – March 2017) and should release performance payments in accordance with the EP contract payment schedules.
EIP January 2016 Rate Adjustment
- January 2016 rate adjustment for EIP is still pending CMS approval.
- Rate adjustment will close the gap between actual EIP DY1 payments and expected EIP DY1 payments.
- DOH will notify affected MCOs and Performing Provider Systems (PPS) once the rate adjustments are approved.
EP Contracting
EP Contracting Update
- If partners choose to modify EP contracts for DY3, MCOs must submit updated contracts to DOH and the IA by no later than Friday, March 31st, 2017.
- EPP measures are final and cannot be changed.
- EIP activities and reporting frequency may be changed annually.
- Payment frequency for both program may be changed annually, but MCOs only receive funds on a monthly basis and cannot pay out before activities are completed for EIP or until they have received payment for EPP.
- Partners can submit either modified contracts or formal documentation signed by both parties highlighting the updates to activities and/or reporting and payment frequencies for the upcoming year.
- MCOs must submit updated contracts to the Independent Assessor (IA) at dsrip_ia@pcgus.com and DOH at dsrip_ssp@health.ny.gov.
- Remember to copy your paired PPS.
EP Reporting
EIP DY2 Q3 Reporting
- DY2 Quarter 3 (Q3) ended December 31, 2016. If PPS elected to report quarterly, reports for the period should have been sent to the entity at the appropriate email address noted below.
- The IA will complete an audit of submissions by Friday, February 3, 2017.
| Report | Completed by | Submitted to | Frequency | Location |
|---|---|---|---|---|
| EP Contracts | PPS & MCO | IA & DOH | Annually | dsrip_ia@pcgus.com dsrip_ssp@health.ny.gov |
| MCO EP Frequency Table | MCO | IA & DOH | Annually | dsrip_ia@pcgus.com dsrip_ssp@health.ny.gov |
| MCO EIP Activity Table | MCO | IA & DOH | Based on EP Contracts | dsrip_ia@pcgus.com dsrip_ssp@health.ny.gov |
| MCO EIP Payment Table | MCO | IA & DOH | Based on EP Contracts | dsrip_ia@pcgus.com dsrip_ssp@health.ny.gov |
| MCO EPP Payment Table | MCO | IA & DOH | Based on EP Contracts | dsrip_ia@pcgus.com dsrip_ssp@health.ny.gov |
| PPS EIP Activity Table | PPS | MCOs | Based on EP Contracts | MCO contact emails |
| Supporting Documentation for EIP Activity participation | PPS | MCOs | Based on EP Contracts | MCO contact emails |
| Supporting Documentation for EIP Activity participation | MCO (reviewed by MCO after being sent by PPS) | IA | Based on EP Contracts | dsrip_ia@pcgus.com |
Next Steps and Open Forum
- The next EP Monthly Update Webinar is scheduled for Wednesday, February 22nd, 2017, from 12:00 pm – 1:00 pm.
- This webinar will include an overview of DY3 guidance, including information to help MCOs’ reporting of accruals.
- Starting in April 2017, EP Webinars will move from a monthly to a quarterly frequency.
- For any further questions, please contact the Supplemental Programs inbox: dsrip_ssp@health.ny.gov.
- The remainder of this webinar is reserved for an open forum session.
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