The New York State Department of Health (NYSDOH) will resume a mailing this month to new Medicaid members to explain the Delivery System Reform Incentive Payment (DSRIP) program´s statewide efforts on healthcare system change and how Performing Provider Systems (PPS) use Medicaid data to improve patient care. The letter will also review the option to not have the member’s data shared by the PPS with provider partners. This is known as “opting out”. The last mailing of this nature was done in August 2016 and did not continue due to vendor procurement processes. Any new members since that time have been marked to not have their data shared until a new mailing to notify them of the choice to opt-out could be completed. This new mailing will begin the week of February 19, 2018. Approximately 2 million Opt-Out letters will be sent to Medicaid members who became eligible since August 2016. Smaller mailings to new members as they become eligible for Medicaid will continue on a monthly cadence through 2019. PPS are responsible for working to improve health outcomes for their Medicaid members, who are seeing the health care providers in the PPS. Data sharing of available Medicaid information is key for effective collaboration among the lead PPS and related network partners for providing and coordinating services to Medicaid members. Data-sharing is very important to getting services to patients and in achieving quality performance and clinical outcomes. If a member agrees to data sharing within the DSRIP program, the Medicaid member does not have to take any action. That data will be shared with the PPS, except for claims related to substance abuse diagnoses and treatment. There is no change to how a Medicaid member seeks care and no change to Medicaid member benefits. If a member chooses to opt out, the form they receive in the mail should be signed and returned in the envelope or the member can call the Medicaid DSRIP opt out helpline at: 1–855–329–8850. Here are important links to find information to help explain DSRIP data sharing and opt out:
Letters can be found at: https://www.health.ny.gov/health_care/medicaid/redesign/dsrip/consumers.htm. This site contains a copy of the Opt Out Letter & Form (mailer) in English, Spanish, and 18-Point Font, as well as the mailer in several different languages for reference purposes only.
Webinar and slide deck to explain the “Opt Out” can be found at: https://www.health.ny.gov/health_care/medicaid/redesign/dsrip/2015-12-02_opt-out_webinar.htm.
FAQs can be found at: https://www.health.ny.gov/health_care/medicaid/redesign/dsrip/opt-out_process_faqs.htm.
Additionally, the Medicaid call center is also open to receive questions regarding the content of this DSRIP mailing. The call center number is 1–855–329–8850.