DSRIP Performing Provider System Letter of Intent

Potential Performing Provider Systems are strongly encouraged to submit non-binding Letters of Intent to the state by May 15, 2014. Letters should be submitted via email to DSRIP@health.state.ny.us. Letters are to be submitted by the potential PPS lead organization and must include the following information:

Required information

• Contact Information: Email, phone, and address for a point person from the lead PPS organization that the state or other interested providers can contact
• Geographic Area: Proposed county(ies) covered by the PPS
• PPS Partnering Providers List: As an attachment to the letter of intent, potential leads must submit use the state-approved template to provide a complete list of other potential providers expected to participate in the PPS.
  • PPS Additional Providers Template (Version 1 - Microsoft 2010-13) (XLSX, 120KB)
  • PPS Additional Providers Template (Version 2 - Microsoft 2007) (XLSX, 174KB)
• Additional Requirement: Letter must include a statement confirming that preliminary conversations around forming a PPS have taken place with all providers on the submitted list

Additional Information regarding DSRIP Letters of Intent

• Letters of Intent will only be accepted from lead providers of a potential PPS; and must include a list of potential partners.
• Letters of Intent will not be accepted from single providers.
• All letters submitted by potential Performing Provider Systems will be posted to DSRIP web
• Letters are to be submitted to dsrip@health.state.ny.us