Advancing Medicaid Payment Reform, New York State Publishes Value Based Payment Reporting Requirements

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On May 26, the New York State Department of Health (“DOH”) published the 2022 Value Based Payment (VBP) Reporting Requirements Technical Specifications Manual, available on the DOH website. Value Based Payment (VBP) refers to the concept by which purchasers of health care and payers hold the health care delivery system accountable for quality and cost of care.

The VBP program developed through the Delivery System Reform Incentive Payment Program (“DSRIP”) that expired on March 31, 2020.  Following DSRIP’s sunset, DOH is using VBP as the path toward Medicaid payment reform. This will incorporate value based concepts into the delivery and payment for Medicaid services. The 2022 VBP Reporting Requirements refer to the 2021 Measurement Year (“MY”) data, except for Managed Long Term Care Plans (“MLTCPs”).  MLTCPs reporting requirements refer to the 2022 MY data. The Specifications Manual is intended to inform VBP stakeholders of the quality measure reporting requirements for Medicaid Managed Care Organizations  (MCOs) that participate in the NYS Medicaid VBP Program.

 

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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