Safety Net Determinations

New York State DOH Vital Access Provider (VAP) Exception Appeal Request:
Medicaid Managed Care Primary Care Providers (PCPs) – Criterion for Safety Net Designation Analysis and Recommendation

New York State Department of Health is requesting an exception from the Centers for Medicare and Medicaid Services (CMS) to the current Safety Net definition policy that would allow additional criterion applicable only to Managed Care plan assigned PCPs for DSRIP purposes. This criterion would employ a statewide threshold, which would confer the PCPs' Safety Net status based on the number of Medicaid members assigned by their respective Managed Care Organizations (MCOs). Under this threshold, PCPs across the state would need to serve more than 25 Medicaid members to achieve the Safety Net designation.

The following documents have been submitted to CMS for review and are open for public comment until August 10, 2016.

Please send comments to dsrip@health.ny.gov with subject line: VAP Exception Appeal Public Comment.

Current PPS Leads Forming New Corporations (NewCo)

During the DSRIP Demonstration Period, PPS Lead entities may decide to pursue different corporate structures to facilitate DSRIP implementation. For this purpose, the NYS DOH will permit current PPS Lead entities ONLY to submit new corporation VAP exception applications for safety net designation. PPS may submit to DOH for consideration their proposal and rationale for the new legal corporation. The requirements for any new PPS corporation are delineated in the PPS NewCo VAP Exception Process guidance issued on September 11, 2015. Such applications will be reviewed by DOH and then posted for 30 day public comment before submitting to CMS for review and approval.

Approved NewCo VAP Exceptions

On December 15, 2016, CMS approved Albany Medical Center PPS VAP exception request to be a safety net provider. The public comment period for this application closed on September 30, 2016. The following links contain the Albany Medical Center PPS application, public comments and CMS approval letter:

Questions can be sent to dsrip@health.ny.gov.

Approved NewCo VAP Exceptions

On January 27, 2016, CMS approved Catholic Medical Partners VAP exception request to be a safety net provider. The public comment period for this application closed on December 30, 2015. The following links contain Catholic Medical Partners application, public comments and CMS approval letter:

On December 10, 2015, CMS approved VAP Exception requests for North Country Initiative, LLC and Leatherstocking Collaborative Health Partners (Bassett) to be safety net providers. The public comment period for these applications closed on November 14, 2015, however, no comments were received during this period. The following links contain the CMS approval letter as well as the applications:

VAP Exception Approvals

The Centers for Medicare and Medicaid Services (CMS) finalized their review of the Vital Access Provider (VAP) Exceptions of providers to participate in DSRIP with a safety net designation and serve as lead entities in a performing providers system (PPS). The links below contain the CMS letters:

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. Non-qualified providers, as a group, cannot receive more than 5 percent of the PPS´ total project value.

Approved Safety Net Providers

The following VAP Exceptions have been approved by CMS. Providers appearing on this list have been designated "Safety Net" status:

Please see the following APPROVED lists of providers that submitted a Safety Net Appeal. Providers appearing on these lists did not have to file a VAP Exception:

Safety Net Determinations

Previously Released Information