Safety Net Q&A; Appeal Deadline Extended from June 4 to June 11

Have Safety Net provider questions? The state Health Department has answers.

Provider lists, posted on the DSRIP web page at http://www.health.ny.gov/health_care/medicaid/redesign/dsrip_safety_net_definition.htm were developed based upon readily available data from various reports filed either with DOH, OASAS, OMH or OPWDD that contained the data needed to determine if a provider meets the respective criteria to be classified as a safety net provider. 

Providers on those lists may appeal using the appeal form process, to provide reevaluation documentation that could allow DOH to determine that the provider may meet specific safety-net criteria. 

This appeal form is not the safety net exception process as allowed by the STCs. A separate form will be posted in the near future to collect that information.

Other Article 28 licensed providers like Assisted Living Residencies, LHCSA’s, Adult Homes, etc., may also use the same form process. 

These providers should indicate their classification in the provider type category under “Other." The volume data needed to be reported in Section III and in the text box to the right on the form provide additional information such as data source and other information.

The state DOH is providing a separate form for Medicaid providers such as Physicians/Physician Groups, Pharmacies, etc..  That form will be posted next week with instructions for completion and a due date.

As a reminder, non-qualifying providers can still participate in Performing Providers Systems. However, non-qualifying providers are eligible to receive DSRIP payments totaling no more than 5 percent of a project’s total valuation.

Further questions arise related to the Safety Net designation should be emailed to BVAPR@ health.state.ny.us

Again, note that the appeal deadline has been extended from June 4, 2014 to June 11, 2014.