Archived Homepage Notices



DateNotice Detail
July 24, 2018

Attention: Timely Billing Webinar is FULL

Due to popular demand, the Timely Filing Webinar with DOH is full. We will send an update through the eMedNY Alert LISTSERV® once more information is available.

Thank you for your patience.

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.

April 9, 2018

Attention: Private Duty Nursing Assessment - Clarification of Acceptable Assessment for Prior Approval of Services

NYCRR Title 10 and Title 18 contains regulations for the provision of Medicaid coverage of Private Duty Nursing (PDN) services in the patient's home. Private duty nursing services may be provided when a written assessment indicates that the member needs either continuous nursing services which are beyond the scope of care available from a certified home health agency, or intermittent nursing services which are normally provided by the certified home health agency but which are unavailable.

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March 16, 2018

Attention: Updated DME Provider Manuals: Procedure Codes and Fee Schedule

Please note, the procedure codes section and fee schedule of the DME Procedure Code manual has been updated for April 1, 2018. Any changes reflected in the manual are effective for dates of service beginning April 1, 2018. 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.

March 13, 2018

Attention: 2018 Hearing Aid Procedure Codes Section and Fee Schedule

Please note, the procedure codes section and fee schedule of the Hearing Aid manual has been updated for April 1, 2018. Any changes reflected in the manual are effective for dates of service beginning April 1, 2018. 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.

March 7, 2018

Attention: New Medicare Card Replacement Initiative: Important Update to Medicare Cards

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. This mandated national undertaking, formerly referred to by CMS as the Social Security Number Removal Initiative (SSNRI), is now known simply as the New Medicare Card replacement initiative.

Click Here To Learn More

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
(518) 473-2160.

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.

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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.

Read More

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.

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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




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