|July 2, 2018||
Attention: Important Payment Information Due to July 4th Holiday
Due to the July 4th holiday, Cycle 2130, will be released on Thursday, July 5th, not Wednesday, July 4th.
This includes the mailing of checks and the release of Electronic Fund Transfers to the provider community.
Please plan accordingly.
If you have questions, please contact the eMedNY Call Center at 1-800-343-9000.
|December 29, 2017||
Attention: 340B Providers: 340B Drugs and Modifier "UD"
Effective Jan 1, 2018:
Hospitals and clinics should continue to identify 340B drugs by entering a value of "UD" on Medicaid Fee for Service claims.
Medicare cross-over (dual eligible) claims should include "UD" in addition to Medicare modifiers: JG or TB.
For billing questions: eMedNY Call Center (800) 343-9000
For policy questions: Division of Program Development and Management
|October 4, 2017||
Attention: Medicaid Managed Care Network Provider Enrollment
The 21st Century Cures Act requires states to require all Medicaid Managed Care (MMC) Network providers to enroll in the fee-for service (FFS) program as either billing or non-billing providers no later than January 1, 2018.
This applies to NYS Medicaid enrollable provider types located on the Provider Index, that participate or will participate in a Medicaid Managed Care or Children's Health Insurance Program network that provides services to, orders, prescribes, or certifies eligibility for services for, individuals who are eligible for medical assistance.
|August 9, 2017||
Attention: New Medicare Card Replacement Initiative
In an effort to combat identity theft and safeguard taxpayer dollars, the United States Congress passed the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 directing the Centers for Medicare & Medicaid Services (CMS) to remove any reference to Social Security Numbers (SSNs) from all Medicare cards by April 2019.
|June 26, 2017||
Attention: Topical Oxygen Wound Therapy (TOWT) Continues to be Covered Until Further Notice
Providers, Medicaid beneficiaries and Medicaid Managed Care Organizations (MMCOs) were notified in the May 2017 Medicaid Update that the New York State Medicaid Program was eliminating coverage of topical oxygen wound therapy (TOWT) effective July 1, 2017.
|June 14, 2017||
Attention: Medical Supply Quantity Update
The following changes in maximum quantities will be effective for dates of service on or after August 1, 2017. Current reimbursement rates are still in effect.
DME Medical Supply Quantity Update
Pharmacy Medical Supply Quantity Update
|April 25, 2017||
Attention: 2017 DME Procedure Codes Section and Fee Schedule
Please note, the procedure codes section and fee schedule of the DME manual has been updated for May 1, 2017. Any changes reflected in the manual are effective for dates of service beginning May 1, 2017. Questions related to policy or coverage guidelines can be directed to the Office of Health Insurance Program's Division of Operations and Systems at OHIPMedPA@health.ny.gov. Billing related questions can be directed to eMedNY at (800) 343-9000.
DME Procedure Codes
DME Fee Schedule
|April 3, 2017||
Attention: Incontinence Supply Management Program
The reimbursement rate changes for Incontinence Supply Management Program products scheduled to take effect April 3, 2017, have been postponed until May 17, 2017. For questions about the Incontinence Supply Management Program, contact the Bureau of Medical Review at 1-800-342-3005 or by email at OHIPMEDPA@health.ny.gov.
|March 24, 2017||
Attention: NEW Provider Communication added for DME and Pharmacy providers
2017 DURABLE MEDICAL EQUIPMENT FEE SCHEDULE CHANGES
|March 9, 2017||
Attention: Care at Home Waiver (CAH) III, IV, and VI Case Management Providers
New Billing Guidance Effective for Dates of Service Beginning April 1, 2017
|March 6, 2017||
Attention: NEW Provider Communications added for DME, Long Term Home Health Care, Managed Care and Pharmacy providers
Incontinence Supply Management Program Fee Schedule Changes
|February 15, 2017||
Attention: Incontinence Supply Management Program Update
Current proposed reductions in incontinence supply fees that were effective for dates of service on or after February 15, 2017 have been postponed until March 15, 2017. Additional information and guidance will be issued prior to effective date.
For questions about the Incontinence Supply Management Program, contact the Bureau of Medical Review at 1-800-342-3005 or by email at OHIPMEDPA@health.ny.gov.
|February 14, 2017||
Attention: NEW Provider Communication added for DME providers
E0445 - Pulse Oximeter Coverage Criteria Update
|December 28, 2016||
Attention: NEW Provider Communications added for DME and Pharmacy providers
2017 DME Procedure Code Changes
|December 13, 2016||
Attention: HealthHelp Customer Experience Survey - Winter 2016
HealthHelp (NYS Medicaid Radiology Prior Approval Services) has released their Winter 2016 Provider Survey. HealthHelp uses this survey to improve their programs, revise processes, and to ensure a better provider experience.
Please take a moment to complete the survey at the following link:
http://www.healthhelp.com/survey -- closed