Updated Safety Net Pharmacies, Provider Lists Online; DSRIP Vital Access Provider Exception Process Opening Soon

Safety Net Vital Access Provider Exception Process:

The state Health Department announced this afternoon that the Vital Access Provider (VAP) Exception appeal process will open as soon as all DSRIP Performing Provider System lists are finalized. Medicaid providers, physicians and pharmacies for facilities that did not qualify by the Safety Net Definition by calculation or by appeal could qualify to apply through the VAP Exception appeal process.   

The VAP Exception (defined in STC 2 of the DSRIP Section of the Partnership Plan Special Terms and Conditions (STCs) as a part of the Safety Net Definition (below) ). There are three categories that a facility may appeal for a VAP exception under:

• A community will not be served without granting the exception because no other eligible provider is willing or capable of serving the community;
• Any hospital is uniquely qualified to serve based on services provided, financial viability, relationships within the community, and/or clear track record of success in reducing avoidable hospital use;
•  Any state-designated health home or group of health homes.

Safety Net Appeal Update:

The state Health Department is currently processing appeals submitted through the second DSRIP safety net appeal process that ended Aug. 27.  Updated lists will be posted as they are finalized. To date, the physician and pharmacy safety net lists have been revised and can be viewed at the following link:

http://www.health.ny.gov/health_care/medicaid/redesign/dsrip_safety_net_definition.htm

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