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For Our Physicians – FAQ

1. Q: What is DSRIP?

A: The Delivery System Reform Incentive Payment (DSRIP) program is the main mechanism by which New York State will implement the Medicaid Redesign Team (MRT) Waiver Amendment.

DSRIP´s purpose is to fundamentally restructure the health care delivery system by reinvesting in the Medicaid program, with the primary goal of reducing avoidable hospital use by 25% over 5 years. Up to $6.42 billion from the MRT Waiver Amendment has been allocated to this program with payouts based upon achieving predefined results in system transformation, clinical management and population health.

2. Q: What is considered avoidable hospital use?

A: Avoidable hospital use encompasses not only avoidable hospital readmissions, but also inpatient admissions that could have been avoided if the patient had received proper preventive care services. The following four measures will be used to evaluate DSRIP´s success in reducing avoidable hospital use:

  1. Potentially Preventable Emergency Room Visits (PPVs),
  2. Potentially Preventable Readmissions (PPRs),
  3. Prevention Quality Indicators- Adult (PQIs),
  4. Prevention Quality Indicators- Pediatric (PDIs).

3. Q: How does the Statewide Health Innovation Plan (SHIP) relate to DSRIP?

A: SHIP and DSRIP can be considered synergistic. SHIP focuses on leveraging the work done with the state on the Patient Centered Medical Home (PCMH) by all payers, as well as the HIT connectivity being built through the Statewide Health Information Network of New York (SHIN-NY). In this context, SHIP will focus, in part, on building the Advanced Primary Care Model from the work done on the PCMH, building the All Payer Database to further build the analytics on health care in New York State, and enhancing the reach and utilization of the SHIN-NY to enhance the coordination and transparency of health care. With these three key pieces in place, quality of care can be monitored more efficiently and effectively, allowing payment reform to focus on payment for outcomes/payment for performance, one other key goal of SHIP.
Please review the SHIP documents on the NYS DOH website for additional details.

4. Q: Where can I get information on DSRIP?

A: The state will provide information through three venues:

  1. The DSRIP website.
  2. The state utilizes a listserv to notify interested parties of updates including webinars.
  3. In addition, there is a dedicated DSRIP email to which questions can be submitted.

5. Q: Is there a DSRIP program timeline available?

A: Yes, it is available on the DSRIP website.

6. Q: How long does the DSRIP program last? What´s a DSRIP year?

A: The DSRIP program is a 5 year program; however, it included one year for planning. The years are structured as follows:

  • DSRIP Year 0 (DY0): April 14, 2014 – March 31, 2015
  • DSRIP Year 1 (DY1): April 1, 2015 – March 31, 2016
  • DSRIP Year 2 (DY2): April 1, 2016 – March 31, 2017
  • DSRIP Year 3 (DY3): April 1, 2017 – March 31, 2018
  • DSRIP Year 4 (DY4): April 1, 2018 – March 31, 2019
  • DSRIP Year 5 (DY5): April 1, 2019 – March 31, 2020

7. Q. What was DSRIP Year 0? How does it differ from the other years?

A: DSRIP Year (DY) 0 was the year for planning, assessment and project development for Performing Provider Systems. The other years, DYs 1 through 5 are for project implementation, performance evaluations & measurement as well as metrics & milestones achievement.

8.Q: What is the Project Approval and Oversight Panel (PAOP)? (New 7/1/2016)

(CMS), required the state and Independent Assessor (IA) to convene a panel to review DSRIP applications scored by an independent assessor and to advise the Commissioner of Health whether to accept, reject or modify those recommendations. The PAOP played an important role in approving DSRIP Project Plans from all areas of the state and will serve as advisors and reviewers of Performing Provider Systems status and project performance during the 5-year DSRIP duration. They will convene during DSRIP Year 2 to review the recommendations put forth by the IA for the Mid-Point Assessment and make recommendations on changes to PPS networks and DSRIP projects. In addition, the PAOP will meet with PPS Leads regionally on a bi-annual basis to receive updates on the status of projects and progress towards goals and objectives.

Information about the PAOP and previous PAOP meetings can be found on the DSRIP website.

9. Q: What are the DSRIP Public Comment Days? (New 7/1/2016)

A: The 1115 Waiver and DSRIP Public Comment Days are provided as opportunities for the public to provide comments and feedback on all 1115 Waiver Programs. The DSRIP program is a significant waiver initiative, and members of the DSRIP Project Approval and Oversight Panel will join DOH staff in listening to the feedback provided by members of the public and stakeholders on these Public Comment Days. Feedback on all waiver programs is welcomed. Each Public Comment Day will be webcast live, and archived. These meetings are also open to the public, with no pre-registration required. All comments will be limited to five minutes per presenter, to ensure that all public comments may be heard.

These Public Comment Days are held regionally, with the downstate Public Comment Day on May 4th, 2016, in New York City and the upstate Public Comment Day on July 12th, 2016 in Albany.

More information on the Public Comment Days, and the link to the archived webcast can be found on the DSRIP website.

DSRIP Eligibility

10. Q: What type of providers/care settings were able to submit an application to participate in DSRIP?

A: The DSRIP program was open to an array of providers across the state. However, different types of providers had to meet certain criteria to be deemed eligible as a DSRIP safety net provider. Being deemed a DSRIP safety net provider allows an organization to be an active participant who is eligible to not only to lead, but also share in the full amount of potential performance payments of a Performing Provider System (PPS) in the DSRIP program.

Eligibility Criteria for Hospitals – Hospitals could qualify as a DSRIP eligible provider by passing at least one of the three tests below.

Hospital Test #1:

  • Must be either a public hospital, Critical Access Hospital or Sole Community Hospital.

Hospital Test #2: (Note that a hospital needs to meet both of these qualifications to pass this test)

  • At least 35 percent of all patient volume in their outpatient lines of business must be associated with Medicaid, uninsured and Dual Eligible* individuals.
  • At least 30 percent of inpatient treatment must be associated with Medicaid, uninsured and Dual Eligible* individuals; or

Hospital Test #3:

  • Must serve at least 30 percent of all Medicaid, uninsured and Dual Eligible* members in the proposed county or multi-county community. (The state will use Medicaid claims and encounter data as well as other sources to verify this claim. The state reserves the right to increase this percentage on a case by case basis so as to ensure that the needs of each community´s Medicaid members are met.)

Eligibility Criteria for Non-hospital based providers – Those not participating as part of a state-designated health home, must have at least 35 percent of all patient volume in their primary lines of business associated with Medicaid, uninsured and Dual Eligible* individuals.

*Dual Eligible Individual: Refers to a Medicaid beneficiary who is also eligible to receive another type of health insurance, including commercial insurance or Medicare.

11. Q: How do I find out if my organization meets the DSRIP safety net qualifications? (Revised 7/1/2016)

A: A list of DSRIP eligible safety net providers is available on the DSRIP website. The lists are divided by provider type into separate PDF documents. Each PDF document contains a complete list of entities within the state for that provider type, regardless whether or not the entity meets the DSRIP safety net provider definition. If a provider sees “True” listed in the “final results” column, then the provider has passed at least one of the eligibility tests and has qualified to be a DSRIP safety net provider. It should be noted that Safety Net determinations might be updated during the mid-point assessment.

12. Q: Is there a way my organization can still participate in DSRIP even if it does not meet the eligibility requirements to be a safety net provider or qualify for a VAP Exception? (Revised 7/1/2016)

A: Yes. As stated in the STCs, non-safety net providers can participate in DSRIP. However, non-safety net providers are eligible to receive, in aggregate, DSRIP payments totaling no more than 5 percent of a project´s total valuation. Please contact your local PPS for possible participation. A list of PPS contact information can be found on the DSRIP website.

13. Q: How is the 5% limit on non-safety net provider performance payments applied?

A: Each Performing Provider System´s DSRIP Project Plan received a maximum monetary valuation during the application process. All providers within a PPS that did not meet DSRIP-eligible safety net provider definition, in aggregate, are only able to receive up to 5% of the performance payments from a project´s total valuation. At least 95% of the performance payment must be made to the safety-net qualified PPS.

14. Q: If private doctors are not considered qualifying safety net providers, would they be subject to the 5% cap?

A: If a private doctor does not meet the DSRIP safety net provider qualifications, they can still participate in a DSRIP PPS either as a non-qualifying provider (subject to the 5% earnings limit) or they could have applied to be part of the PPS through meeting the DSRIP Vital Access Provider (VAP) Exception criteria. (See Page 6, What was the DSRIP VAP Exception and how does it pertain to DSRIP safety-net eligibility?)

15. Q: Since an Independent Practice Association (IPA) is not a Medicaid provider per se, can it be a PPS partner because its physician members are Medicaid providers or do the physicians need to participate in the PPS as individual practitioners?

A: The IPA would be a non-qualifying partner, and would be limited to 5% of total project valuation. However, the IPA can assist qualifying providers in their network. Examples include:

  1. Helping members qualify as safety net providers,
  2. Providing technical assistance on meeting DSRIP project goals, and
  3. Negotiating on their members´ behalf in establishing Performing Provider Systems.

DSRIP Eligibility Appeals

16. Q: Based on the safety net list on the DSRIP website, my organization was listed, but did not meet the qualifications to be a safety net provider in the DSRIP program. Can my organization appeal if we feel there was an error in the data used to determine eligibility?

Please review the DSRIP Safety Net Provider lists available on the DSRIP website.

The second and final DSRIP safety net appeal process is closed. Providers who were not included on the eligible provider lists above, and believed that they had met the safety net definition had the opportunity to appeal their safety net provider status. These appeals were due August 27, 2014. Late appeals were not accepted. Please note that the safety net appeals process was NOT for entities who were looking to pursue the DSRIP Vital Access Provider (VAP) Exception process, which closed October 24, 2014. A final posting of Safety Net lists and VAP Exceptions was finalized and posted on the DSRIP Safety Net Definition website.

17. Q: What was the DSRIP VAP Exception and how does it pertain to DSRIP safety-net eligibility?

A: Under the DSRIP Vital Access Provider (VAP) Exception, the state considered exceptions (to the safety net definition) on a case-by-case basis if it was deemed in the best interest of Medicaid members and made clear that the provider system in question provides essential benefits within the larger system. The list of approved VAP Exceptions are on the DSRIP website. The application period for VAP Exception is closed and no new providers will be added to the list at this time. Those providers that received a DSRIP VAP Exception will be viewed as a qualifying safety net providers in regards to the DSRIP program and will be eligible to share in safety net portion (?95%) of performance payments allotted to a PPS.

There were three reasons under which DOH and CMS would grant a VAP Exception in the DSRIP program:

  1. A community would not be served without granting the exception because no other eligible provider is willing or capable of serving the community.
  2. Any hospital 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.
  3. Any state-designated Health Home or group of Health Homes.*

*The Department submitted a draft list to CMS of those State Designated Health Homes and Network Care Management Agencies (CMAs) that had been previously approved as safety net providers, as well as those that were pending approval by CMS. The list of State Designated Health Homes and CMAs is posted to the Safety Net section of the DSRIP website. Initially, you did not need to submit a VAP Exception form if:

  • Your Health Home appeared on the draft list as pending approval, as you would be granted a VAP Exception following CMS approval.
  • The organization operating your Health Home/CMA already appeared on another safety net provider list.

If your Health Home organization did not appear on the draft Health Home list pending CMS approval, or on another approved safety net provider list, but your organization believed that it should qualify as a Health Home, you were asked to complete the VAP Exception form.

18. Q: How do I apply for a Vital Access Provider Exception? (Revised 7/1/2016)

A: The Vital Access Provider Exception process is now closed. *The form to apply for a VAP Exception was posted on the DSRIP website in late September 2014. VAP Exception applications were due by October 24, 2014 and made public on the DSRIP website immediately for a 30-day comment period. CMS approval of exceptions were posted to the website in February 2015.

*During the DSRIP Demonstration Period, PPS Lead entities may have decided 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.

Performing Provider Systems (PPS)

1. Q: What is a Performing Provider System?

A: The entities that are responsible for creating and implementing a DSRIP project are called “Performing Provider Systems”, abbreviated “PPS”. Performing Provider Systems are providers that form partnerships and collaborate in a DSRIP Project Plan. PPS includes both major public hospitals and safety net providers, with a designated lead provider for the group. Safety net partners can include an array of providers: hospitals, health homes, skilled nursing facilities, clinics & FQHCs, behavioral health providers, community based organizations and others. Performing Provider Systems must meet all requirements described in the Special Terms and Conditions (STCs), including the safety net definition described in STC VIII.2.

2. Q: Can a provider still join a PPS at this point in time? If yes, can you still participate in the financial incentive payment? (Revised July 2016)

A: At this time, the PPS provider networks are closed. However, annually PPS networks will reopen for the addition of new partners for performance purposes only. We recommend reaching out to the PPS in your region regarding participation. A list of PPS contact information can be found on the DSRIP for Providers & Professionals website.

3. Q: What is required of a DSRIP Performing Provider System?

A: It is important to understand that DSRIP payments are made based upon project performance. A PPS will be required to perform a community assessment of need, identify DSRIP strategies that are most consistent with addressing that need, develop a Project Plan incorporating those strategies, implement that Project Plan and monitor milestones and metrics to ensure the implementation is successful. There are certain strategies that will be required of all PPS. It is expected that at the end of the DSRIP program, the health care delivery system for Medicaid members and other New Yorkers will look fundamentally different, with greater focus on high quality ambulatory care and a de-emphasis on hospital inpatient and ED care, helping to meet the state goal of reducing avoidable hospital use, including emergency department and inpatient, by 25%.

4. Q. If Medicaid makes up only a portion of a provider´s book of business, what are the impacts of the DSRIP program on the rest of a provider´s business?

A: The DSRIP program is an initiative specifically targeted to Medicaid and the uninsured population. However, as PPS entities work to transform their service delivery system and payment structure, the state expects that the DSRIP program will act as a catalyst for change to other parts of a provider´s book of business. In addition, pay for performance or value based purchasing by government and private insurers is becoming much more widespread, supporting the transformative changes from DSRIP.

5. Q: Can a provider be a member of more than one PPS?

A: Yes. There is no requirement in the DSRIP program stating that a provider or organization can only join one PPS. Providers that serve large geographic areas which cross medical markets may join two (or more) PPS networks to best serve their patients.

However, providers who are considering joining multiple PPS should understand that there can be some drawbacks. Firstly, the attribution an organization brings to a PPS will diminish with each additional PPS the provider/organization joins. For example, if a clinic joins two PPS in the same county, the clinic´s attributed members will most likely be split between the two PPS networks it is partnered with. This could harm the clinic´s performance payment negotiations with each PPS, because the clinic will bring fewer lives to each PPS. Additionally, the clinic may see that there are greater administrative and reporting demands placed on the entity as it has to be responsive to two PPS.

For more information on attribution logic, see section titled “Attribution” or the presentation on Attribution and Valuation.

6. Q: Are providers encouraged to work together? If so, what types of providers can collaborate as partners?

A: It is a requirement that eligible providers within a region/service area work together on a DSRIP project. Significant community collaboration by Medicaid and non-Medicaid providers is a key theme of DSRIP and is necessary in order to meet the performance aims of DSRIP.

Within a PPS there should be a wide variety of providers including hospitals, clinics, primary care physicians, specialists, home care, SNF, Health Homes, and behavioral health providers. Also, community based organizations such as housing providers should be key participants so that the PPS will have resources in the community and be able to address the social determinants of health.

7. Q: Will there be collaboration between PPS?

A: Yes. Collaboration between PPS is critical to the overall success of DSRIP. Collaboration in general is seen as necessary for ensuring downstream providers are able to achieve clinical integration with PPS, particularly since many downstream providers may be engaged with multiple PPS. For this reason, the extent to which there is project overlap between regions with a similar patient base (based on a single community needs assessment as has been done in Westchester, Brooklyn and Long Island, for example), collaborative efforts between PPS will be a key lever to making sustainable change in a region.

Also, from DY1-DY5, PPS will be required to take part in DSRIP Learning Symposiums. These learning collaboratives will take place in person no less than once a year and will foster an environment of mutual assistance. PPS will be encouraged to share best practices and challenges, and receive assistance and guidance from other PPS counterparts on how to best implement and meet the objectives of their DSRIP Project Plans. This will be particularly important as, starting in DY3, CMS will be evaluating summative statewide performance on DSRIP benchmarks. There will be performance payment reductions across the board to all PPS if those statewide benchmarks are not met.

8. Q: Are there any signed attestations required to confirm DSRIP Partnership?

A: Yes. Every PPS Lead partner is required to submit an attestation statement documenting that each partner included in its Network Tool partner list has formally consented to be part of the PPS. Attestation was required BOTH times the Network Tool was used – for initial and final attribution for valuation. PPS Lead partners are responsible for maintaining a file of signed partnership agreements from all partner organizations that can be made available to the state and/or CMS upon request.

If for any reason it is found that partner lists have been manipulated or inappropriately prepared, the Office of the NYS Medicaid Inspector General, as well as CMS, will be notified and appropriate action will be taken. If the PPS Lead partner does not have a signed partnership agreement with a provider, the lead entity should refrain from adding that provider to their partner list in the Network Tool.

9. Q: What is the DSRIP Network Tool?

A: The DSRIP Network Tool is an electronic tool housed in New York´s Medicaid Analytics Performance Portal (MAPP), a web-based portal accessed through the Health Commerce System (HCS). The Network Tool is the means by which PPS entities updated/replaced their list of partner organizations during the DSRIP planning process. Providers were required to update their partner organization list, using this tool, by September 29, 2014, so that the state could begin the process of running initial attribution. PPS could continue to edit their partner organization lists via the Network Tool until December 1, 2014 when the tool was closed for the state to run attribution for valuation. The network for valuation is locked and closed for changes at this time. The network tool to add providers for performance, however, is opened annually.

For more information on the DSRIP Network Tool, please visit the DSRIP Medicaid Analytics Performance Portal (MAPP) website.

10. Q. Can you explain why there are some providers listed on the performance list that are not on the valuation list?

A: Each PPS has two partner network lists in the MAPP System: a valuation network and a performance network. Networks for valuation were closed December 1, 2014 and were used to attribute members for purposes of calculating valuation. Valuation networks were locked and will not be changed – it is basically a snapshot of the PPS on that date.

However, as the DSRIP program goes forward, PPS will need to change their networks and add providers as they expand services or need a specific type of provider to meet their objectives. Hence, a performance network can change during the course of the DSRIP program. Providers cannot be removed, but can be added; the performance network should be larger than the valuation network. This is why you will see some providers on the performance network, but not on the valuation network. The performance network is used to set baselines and then to measure performance on a quarterly basis.

11. Q: How is a partner defined for the network list?

A: The DSRIP program is open to an array of health providers and health-related and community service entities/providers across the state. These providers come together and partner with a PPS to develop and implement a DSRIP Project Plan. In the context of DSRIP, PPS partners are those providers that a PPS Lead submits as part of its PPS in the DSRIP Network Tool. PPS partners included in the Network Tool can be DSRIP safety-net qualified and non-safety net qualified entities, as well as providers who do not directly bill Medicaid.

What a PPS should consider in making an entity a partner rather than an outside contractor is whether or not the partner will be in a performance-based relationship with the PPS in implementing its DSRIP Project Plan. If the entity will be held accountable for performance in helping the PPS reach its DSRIP objectives, it will be important for the entity to be included as a partner to ensure alignment, and they should sign a formal participation agreement with the PPS documenting this participation and alignment.

12. Q: What is required for the network partnership agreements?

A: All PPS Leads were required to have signed partnership agreements from each partner in their files by the time they submitted their final partner list via the Network Tool. Partnership agreements must relate to the DSRIP program and connect the entities together for DSRIP attribution and program purposes. The state is not providing a standardized template, but issued the following guidance:

  1. PDF copies of the signed agreements are sufficient (meaning all these agreements can be kept electronically).
  2. These agreements do not have to be notarized.
  3. Each individual physician in a practice group does not have to submit their own letter; but, rather, a signed letter from the practice CEO stating that all the practitioners in a practice/organization are authorized to be added to a PPS´s list is sufficient.

For IPAs, if they have opt-out rules, then the PPS requires one letter from the IPA CEO to add all providers to the PPS. If the IPA has opt-in rules, then the PPS will need to collect signatures from each member of the IPA that they wish to include in their network.

13. Q: What happens if a partner drops out of the DSRIP process due to financial issues?

A: Financial sustainability is a key end point that the PPS will need to attain. It is expected that the transformation of the health care system will result in changes in provider mix, some increases and some decreases. These should be well understood based upon the comprehensive community needs assessment and considered in the developing of projects. A PPS should do its best to try to limit the risk of partners leaving the PPS due to financial issues by (1) allocating DSRIP performance funds within the PPS to aid partners in this situation, as well as (2) help those providers set up adequate restructuring plans to secure financial sustainability over the course of DSRIP and beyond.

Additionally, PPS governance plans must address how the PPS proposes to manage lower performing / financially distressed members within the PPS network. This plan must include progressive sanctions prior to any action to remove a member from the performing provider system. Unless the partner organization closes or there is some other extreme circumstance, PPS will not be able to alter their partner lists for valuation purposes. A PPS may add partners at a state-chosen time, but no more than once a year.

14. Q: Can you remove partners after finalizing your partner list? (Revised 8/28/2015)

A: PPS networks were submitted via the DSRIP Network Tool for the purposes of calculating attribution for valuation and later, attribution for performance.

No more than once a year, Performing Provider Systems may submit proposed modifications to an approved DSRIP Project Plan for state and CMS review. These modifications may not decrease the scope of the project unless they also propose to decrease the project´s valuation.

Removal of any PPS member organization requires a proposed modification, and removal of any such lower performing member must follow the required governance procedures including progressive sanction requirements.

15. Q: Can you add partners after finalizing your partner list?

A: Once a year, the state will open performance networks and PPS may add partners. Please note, additional partners will be for performance purposes only.

16. Q: What provider types qualify to be lead applicants in a DSRIP Performing Provider System?

A: Any qualifying DSRIP safety net provider could be a lead applicant, regardless of provider type. However, in the DSRIP Project Plan, the lead applicant was assessed on its ability to fulfill the role as the lead entity within the Performing Provider System. Qualifications that could have allowed an entity to fulfill the role as the lead applicant includes, but were not limited to:

  1. Previous collaborative experience,
  2. Unique leadership capabilities,
  3. Administrative capabilities,
  4. Financial stability.

It should be noted that while all PPS entities, as a whole, undergo a financial evaluation to ensure the entity´s ability to complete the program, lead organizations underwent a more intensive, individual financial assessment to ensure fiscal stability for the PPS through the DSRIP program. Furthermore, new governing structures (“NewCos”), rather than individual safety net providers, can serve as leads for Performing Provider Systems in the DSRIP program.

17. Q: Within a PPS network, how much autonomy does a PPS have in distributing funds?

A: A PPS has the autonomy to allocate performance funds how it best sees fit, as long as at least 95% of performance payments go to safety net qualified partners and no more than 5% go to non-qualifying safety net partners. However, PPS funds allocation must be described in the DSRIP Budget & Flow of Funds section of the Project Plan Application and include a description of how DSRIP performance payments will be distributed amongst providers, and how the distribution of funds is consistent with the governance structure and DSRIP goals.

After DSRIP payments are received from the PPS Lead, partners are not restricted from making payments to other in-network or out-of-network providers (e.g., contracts for DSRIP-supportive services). Once a performance payment is properly received, the DSRIP program does not impose any additional restrictions on these funds.

The PPS Lead must have established a budget and funding distribution plan, (at the level of detail set forth in the DSRIP Project Plan Application and Award Letter and the DSRIP Implementation Plan) that specifies how DSRIP funds received are distributed among the participating providers in the PPS to incentivize providers to reach DSRIP performance goals. The PPS Lead in its budget plan needed to provide a distribution methodology taking into account five different categories:

  • Project implementation costs
  • Costs for delivery of services not reimbursed or under-reimbursed by Medicaid
  • Provider performance payments
  • Compensate revenue loss
  • Other for administrative and other costs not included in previous categories

18. Q: Will PPS networks be protected from laws on anti-competitive behavior?

A: Yes, in instances where a DSRIP PPS can show that a potential collaboration between providers will benefit the community, there will be an opportunity for the state to provide protections for a PPS. This protection will come in the form of a Certificate of Public Advantage (COPA), which will be granted if it appears that the benefits of a collaboration between PPS partners will outweigh any disadvantages attributable to their anticompetitive effects and will be subject to active state supervision. COPA regulations are explicated in Article 29-F of New York´s Public Health Law.

More information on COPA in relation to DSRIP is available at: http://www.health.ny.gov/health_care/medicaid/redesign/copa/index.htm

19. Q: Will a data sharing agreement with the state be required? (Revised 7/1/2016)

A: Yes. The state will be delivering provider-specific Medicaid information through a DSRIP portal, Medicaid Analytics and Performance Portal (MAPP).

Minimally, a Data Exchange Application and Agreement (DEAA) will need to be executed with the state for data available in the portal and any data sharing outside of the portal. Additionally, PPS are required to have established Health Commerce System (HCS) accounts to access the DSRIP portal (MAPP).

Further information is available in the Data Sharing section of this FAQ, or in the DSRIP Data Sharing FAQ.