Vital-Access Appeals

Crain’s Health Pulse

November 6, 2014

Vital-Access Appeals

The names of doctors, hospitals and other groups who appealed to get Vital Access Provider status were posted Monday on the DSRIP website  for a 30-day public comment period. PPS participants denied safety-net status during the first round of negotiations need a VAP exception, or otherwise are limited to no more than 5% of funding. Public health advocates were surprised to see academic medical centers like NYU and North Shore University Hospital on the list. The two “should no way be approved for safety-net status,” said Judy Wessler, former director of the Commission on the Public's Health System, in an email. “In past waivers, AMCs have managed to get a lot of money. And do we have anything to show for it? I don’t think so,” she said. “These are not low-reimbursed care institutions.” NYU Langone, with a payer mix of 14% Medicaid patients, wrote in its application that it needed VAP status “to strengthen a clinical partnership” with Lutheran Medical Center and to jointly lead a Lutheran PPS. And NSUH, with a 12% Medicaid mix, noted it “serves a higher volume of Medicaid patients than other hospitals in the county that qualify as safety-net providers, though it is just shy of satisfying the safety-net definition based on the percentage of Medicaid patients that it treats.”

 

Topics: DSRIP

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