VAP Exception Appeal Public Comment-Transition of Lead PPS Organization from AMCH to BHNNY

DEPARTMENT OF HEALTH & HUMAN SERVICES
Centers for Medicare & Medicaid Services
7500 Security Boulevard, Mail Stop S2–01–16
Baltimore, Maryland 21244-1850

State Demonstrations Group


December 15, 2016

Jason Helgerson
Director
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 a determination for granting a vital access provider 01AP) exception under New York´s delivery system reform incentive payment (DSRIP) program. CMS has made safety–net provider determinations for provider systems that have applied for a safety net provider designation after creating not–for–profit new corporations ("newco´´) that meet the criteria outlined in the Standard Terms and Conditions (STCs). After a review of the request, CMS has determined that Better Health for Northeast New York, Inc. (BHNNY) meets the criteria and is approved to participate in DSRIP as the lead entity in the performing provider system (PPS).

DSRIP participation as a safety net provider is contingent upon New York´s assurance that the PPS consist of all safety net providers, that non–qualifying providers will not be added to the PPS without applying for another VAP exception, and that non–qualifying providers are eligible to receive DSRIP payments totaling no more than 5 percent of a project´s total valuation. New York also assures that BHYNNY will not 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 DSRIP project funding from the Safety Net Performance Provider System Transformation Fund.

Your project officer, Deborah Steinbach, can be reached by phone at (410) 786–7404, or by e–mail at Deborah.Steinbach@cms.hhs.gov, should you need to contact her. We look forward to continuing to work with you and your staff on your 1115 demonstration.

Sincerely,

Angela D. Garner
Director, Division of System Reform Demonstrations

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