The Department of Health and Xerox State Healthcare, LLC are working diligently on the design and development of the new Medicaid system, called NYMMIS.
NYMMIS has an interim website created as an "information billboard." It will be used as a main source for communicating information, providing updates and email bulletins regarding the implementation of the new system. In addition updates will be provided on a regular basis in an effort to share relevant NYMMIS information and its potential impact on providers' business processes. Our interim website is also hosting a ListServ signup section. Once you sign up we will be able to email you with timely and updated news on the project and how it will affect you.
This notice is to advise impacted providers that effective May 8, 2015, the 2 percent Across-the-Board Medicaid payment reduction will be eliminated for claims with service dates on or after April 1, 2015. This change will be reflected in checks issued in Cycle 1969 (checks dated May 18, 2015 with a release date of June 3, 2015). The retroactive repayment of the reduction taken over the period April 1, 2014 through March 31, 2015 is still pending federal Centers for Medicare & Medicaid Services (CMS) approval.
Please note, the fee schedule of the DME Manual has been updated for June 1, 2015. Any changes reflected in the manual are effective for dates of service beginning June 1, 2015. Questions related to policy or coverage guidelines can be directed to the Office of Health Insurance Program's Division of OHIP Operations at OHIPMedPA@health.ny.gov. Billing related questions can be directed to CSC at (800) 343-9000.
Please note, the fee schedule of the Pharmacy Manual has been updated for June 1, 2015. Any changes reflected in the manual are effective for dates of service beginning June 1, 2015. Questions related to policy or coverage guidelines can be directed to the Office of Health Insurance Program's Division of OHIP Operations at OHIPMedPA@health.ny.gov. Billing related questions can be directed to CSC at (800) 343-9000.
The following provider manuals and fee schedules have been updated for April 1, 2015:
Clinical Psychology, Clinical Social Worker, Laboratory, Midwife, Nurse Practitioner, Pharmacy, Podiatry, Rehabilitation Services, and Vision Care.
On July 28, 2014 eMedNY opened the Provider Testing Environment (PTE) for submitters to begin testing Medicaid claims with ICD-10 diagnosis codes. In addition inpatient hospital claims that utilize ICD-10 procedure codes may be tested beginning on this date.
Date of Service Requirement
When submitting test claims with ICD-10 codes submitters must use a date of service of July 1, 2014 or any date of service up to the date of the test submission. Future dates are not allowed. Submitters who may be testing claims with ICD-9 codes must use a date of service prior to July 1, 2014.
ATTENTION: MEDICAID NOW REQUIRES ALL BILLING PROVIDERS TO REGISTER FOR ELECTRONIC FUNDS TRANSFER (EFT) PAYMENTS AND EITHER ELECTRONIC REMITTANCE ADVICE (ERA) OR PDF REMITTANCES.
Billing providers who have not registered for EFT and ERA or PDF remittances will not be allowed to re-certify their Electronic Transmitter ID Number (ETIN). When the ETIN expires a provider's claims will be rejected by eMedNY. It is therefore very important that providers who have not registered for EFT and ERA or PDF remittances do so right away. Waiting for your ETIN to approach expiration will jeopardize your payments.
This website is provided as a service for providers and the general public, as part of the offerings of the electronic Medicaid system of New York State. You'll be able to find helpful manuals and reference material, and get answers to questions about New York Medicaid. The site is updated regularly to meet the ever-growing needs of the New York State provider community. If you need help finding what you're looking for, please visit our Site Map, use the search above, or you can contact us directly for assistance.