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DOH Medicaid Update Index - M

Magnetic Resonance Imaging (MRI)

Physician and Clinic Billing for Magnetic Resonance Imaging - May 2002

Malnutrition

Attention All Hospital Providers: Medicaid Fee for Service and Medicaid Managed Care Billing Guidance for Diagnosis of Malnutrition - May 2019

Mammography Services

New York State Medicaid Coverage of Digital Breast Tomosynthesis Three-dimensional Mammography - August 2017

Managed Long Term Care (MLTC)

Special Income Standard for Housing Expenses - September 2018
2018-2019 Enacted Budget Initiative: MLTC Partial Capitation Plans Enrollment Lock-In - June 2018
Managed Long-Term Care Plan Closure Oversight - April 2018
MLTC Partial Capitation Plans Contracting with Licensed Home Care Service Agencies - April 2018
Resource Verification Indicator Added to Provisional Coverage (06) Eligibility Response and Targeted MLTC Enrollment - June 2014
Reminder of Upcoming UAS-NY Milestone for Managed Long Term Care Plans - July 2013
UAS-NY Implementation Update - June 2013
Uniform Assessment System for New York (UAS-NY) Timeline Revised for MLTCPs - May 2013
Mandatory Enrollment Plan for MLTC and Care Coordination Models Receives CMS Approval - October 2012
Special Income Standard for Housing Expenses - October 2012
Mandatory Enrollment Plan for MLTC and Care Coordination Models Receives CMS Approval - September 2012
Roll Out of New Enrollment Plan for Mandatory Managed Long Term Care and Care Coordination Models - April 2012

Management Addiction Treatment Services (MATS)

Attention Ambulance Services: The Centers for Medicare and Medicaid Services' Emergency Triage, Treat, and Transport (ET3) Model - December 2020
Clarification of Requirements for Ambulance Transports Originating from Hospitals - August 2018
Medicaid Transportation Ambulance Rate Increase (Cover) - April 2018
Attention NYC Ambulance Providers: Add-on Mileage for Certain Trips Now Available - June 2015
New Fee Schedule for Air Ambulance Trips - June 2015
New York State Medicaid Health Homes - November 2012

Mandatory Generic Drug Program (ManGen)

Mandatory Compliance Program Certification Requirement under 18 NYCRR §521.3(b) - December 2013
NY Medicaid mandatory generic drug program requires PA for brand-name prescriptions with an A-rated generic equivalent - March 2010
Mandatory Generic Drug Program Update - November 2009
Mandatory Generic Drug Program Update - April 2009
Mandatory generic drug program update - October 2008
EPIC Update - New York's Prescription Coverage for Seniors - July 2008
Mandatory Generic Drug Program Update - May 2008
Mandatory Managed Care for SSI and SSI-Related Medicaid Enrollees - January 2008
Prescribers: Prior Authorization Requirements of the Mandatory Generic Drug Program - January 2008
Pharmacy Prior Authorization General Information - December 2007
Mandatory Generic Drug Program Update - November 2007
Mandatory Generic Drug Program Update - May 2007
Mandatory Generic Drug Program Update - January 2007
Please Consult the Medicaid Preferred Drug List - December 2006
Mandatory Generic Drug Program - November 2006
Helpful Tips for Pharmacists When Validating Prior Authorization Numbers - September 2006
Helpful Prior Authorization Tips for Prescribers - September 2006
Important Prior Authorization Pharmacy Phone Numbers - July 2006
Preferred Drug Program Implementation - July 2006
Mandatory Generic Drug Program Update - April 2006
Mandatory Generic Clarification - September 2005
News Flash: Did You Know that Medicaid Pharmacy Information Can be Found on Our Website? - August 2005
Mandatory Generic Drug Program Update - July 2005
Mandatory Generic Drug Program Update - May 2005
Prescribers and Pharmacists: Mandatory Generic Drug Program Update - January 2005
Mandatory Generic Drug Program Update - September 2004
Mandatory Generic Program Reminders - May 2003
Mandatory Generic Program News - March 2003
Mandatory Generic Program Reminder - December 2002
Recap of Mandatory Generic Drug Program - November 2002
Medicaid Mandatory Generic Drug Program Announcement - October 2002
Information for Pharmacists: Prior Authorization for an Emergency Supply or When the Generic is not Available - October 2002
Section 5: Frequently Asked Questions about the Mandatory Generic Drug Program - October 2002
Section 4: Recipient Information - October 2002
Section 3: How to Request that a Brand-Name Drug be Exempted from the Mandatory Generic Drug Program - October 2002
Section 2: Instructions for Pharmacists - October 2002
Section 1: Instructions for Prescribers - October 2002
Mandatory Generic Program Date Changes - September 2002
New Medicaid Law - Mandatory Generic Drug Program - August 2002
New Medicaid Mandatory Generic Program to Begin Exemption Form Available - July 2002

Marinol ® (dronabinol)

Medicaid Pharmacy Prior Authorization Programs Update - May 2013

Medicaid Card

Medicaid Newborn Reporting and Billing Procedures for Hospitals in New York State - March 2021
New Medicare Card Replacement Initiative - September 2017
Pharmacy Customer Posting - December 2013
New York State Benefit Identification Card Undergoes Changes - April 2009
New Type Of Common Benefit Identification Card To Be Issued - January 2004
Recipient Responsible to Show Medicaid Card - August 2002
Medicaid Services for Newborn Infants - July 2000
Attention All Providers - March 1999

Medicaid Fee For Service (FFS)

New York State Medicaid Fee-for-Service Retroactive Repricing for COVID-19 Vaccine Administration Reimbursement for Professional and Pharmacy Claims - May 2021
Medicaid Pharmacy Carve-Out: Delayed by Two Years, until April 1, 2023 (Cover) - May 2021
Medicaid Pharmacy Carve-Out (Cover) - March 2021
Submission Guidance for Fee-for-Service Claims with Third Party Liability (Medicare or Other Insurance) - December 2020
Fee-For-Service Reminders from the Bureau of Dental Review - September 2020
New York State Medicaid Fee-for-Service Policy and Billing Guidance for Onasemnogene Abeparvovec-xioi (ZOLGENSMA®) - November 2019
Medicaid Fee-for-Service: Procedure Code Modifier 'ST' for Occupational, Physical, or Speech Therapy Services Provided to a Member with a Traumatic Brain Injury (TBI) - November 2019
The Medicaid Enrolled Provider Listing (Formerly the Medicaid Fee-for-Service (FFS) Directory) - November 2019
Billing Guidance for Reporting Alternate Level of Care - July 2019
New York State Medicaid Expansion of Prognostic Tests for Breast Cancer Treatment - July 2019
Reminder: Pharmacy Delivery Policy - July 2019
Medicaid Pharmacy Prior Authorization Programs Update - July 2019
Pharmacy Fee-for-Service Billing Guidance: Long Term Care and Foster Care (Child Care) Facilities - June 2019
Reminder: Authorized Agents for Prior Authorizations of Prescription Drugs - June 2019
Medicaid Coverage of Limited Infertility Benefit - June 2019
Opioid Treatment Plan Follow Up - May 2019
Reminder: Substance Use Disorder Drug Treatment, Medicaid Managed Care and Fee-for-Service Coverage - May 2019
Attention All Hospital Providers: Medicaid Fee for Service and Medicaid Managed Care Billing Guidance for Diagnosis of Malnutrition - May 2019
New System Edit on Fee-for-Service Pharmacy Claims for the Vaccines for Children Program - May 2019
Reporting of the National Drug Code is Required for all Fee-for-Service Physician Administered Drugs - April 2019
Pharmacy Reminder: Emergency Contraceptive Coverage (cover) - April 2019
Reminder: Revalidation of Medicaid Providers is Required - March 2019
Reminder: Reporting of the National Drug Code is Required for all Fee-for-Service Physician Administered Drugs - March 2019
Reminder: Medicaid Billing for Vaccines for Children - February 2019
Reporting of the National Drug Code is Required for all Fee-for-Service Physician Administered Drugs - February 2019
NYS Medicaid FFS Retroactive Repricing per Prior Changes Made to Pharmacy Reimbursement - January 2019
Patient-Centered Medical Home Model - November 2018
Advanced Primary Care Incentive Payment Program - November 2018
Patient-Centered Medical Home and Advanced Primary Care Incentive Payment Programs: Comprehensive Payment Policy and Billing Guidance - November 2018
Medicaid FFS Removing NDCs (Cover) - October 2018
Reminder: Handling Prescription Transfers in Medicaid Fee for Service - September 2018
Skin Substitutes in the Office Setting - July 2018
Update on Medicaid FFS Pharmacy Billing Instructions for Coordination of Benefits Submission - July 2018
Medicaid Pharmacy Prior Authorization Programs Update (cover) - July 2018
Additional Codes Added to the Nurse Practitioner Fee-for-Service Fee Schedule - May 2018
Coverage of Preferred Diabetic Test Strips and Lancets - March 2018
Changes to Medicaid FFS Pharmacy Reimbursement To Be Implemented February 22, 2018 - January 2018
Medicaid FFS Pharmacy Change in Early Fill Edit for Controlled Substances - January 2018
Reminder: Payment Policy for Global Surgery Periods - January 2018
Change in Medicaid Fee for Service Billing for Flu Vaccine Administration for Children Between the Ages Of 2 Years And 18 Years - January 2018
NYS Medicaid Fee-for-Service NCPDP D.0 Billing Clarification For 340B Drug Claims - October 2017
NYS Medicaid FFS Program Pharmacists as Immunizers Fact Sheet - September 2017
Integrated Services: Guidance for Licensed/Certified Facilities, including Billing under FFS and Medicaid Managed Care - September 2017
Medicaid Fee-For-Service Implementing Edits to Limit Initial Opioid Prescribing to a Seven Day Supply (cover) - August 2017
Update on Medicaid Fee-for-Service (FFS) Pharmacy Billing Instructions for Coordination of Benefits (COB) Submission - July 2017
Changes to Medicaid Fee-For-Service Pharmacy Reimbursement per CMS Final Rule on Covered Outpatient Drugs and the Enacted 17/18 Budget - July 2017
Update: Emergency Contraceptive Coverage - March 2017
Update on the Smoking Cessation Benefit in Medicaid Fee-for-Service and Medicaid Managed Care - March 2017
Attention Family Planning Providers: Medicaid-covered Long Acting Reversible Contraceptives - March 2017

Medicaid Health Homes

Billing Guidance for Reporting Alternate Level of Care - July 2019
New York State Medicaid Expansion of Prognostic Tests for Breast Cancer Treatment - July 2019
Reminder: Pharmacy Delivery Policy - July 2019
2019 Medicaid Managed Care Primary Care Providers: Access and Availability - June 2019
Reminder: Authorized Agents for Prior Authorizations of Prescription Drugs - June 2019
Medicaid Coverage of Limited Infertility Benefit - June 2019
Opioid Treatment Plan Follow Up - May 2019
Reminder: Substance Use Disorder Drug Treatment, Medicaid Managed Care and Fee-for-Service Coverage - May 2019
Attention All Hospital Providers: Medicaid Fee for Service and Medicaid Managed Care Billing Guidance for Diagnosis of Malnutrition - May 2019
Behavioral Health Transition to Medicaid Managed Care for Children Under 21 Years of Age - May 2019
Pharmacy Reminder: Emergency Contraceptive Coverage (cover) - April 2019
Reminder: Revalidation of Medicaid Providers is Required - March 2019
Reminder: Medicaid Billing for Vaccines for Children - February 2019
Health Home Program Announces New Recipient Restriction/Exception Codes - August 2018
Integrated Services: Guidance for Licensed/Certified Facilities, including Billing under FFS and Medicaid Managed Care - September 2017
Health Homes - July 2015
Revised New York State Medicaid Requirements for Home Health Providers and Verification Organizations - May 2015
Update on the Health Home Consent Process - December 2012
New York State Medicaid Health Homes - November 2012
Introducing Health Homes - April 2012

Medicaid Managed Care (MMC)

Medicaid Pharmacy Carve-Out: Delayed by Two Years, until April 1, 2023 (Cover) - May 2021
Medicaid Pharmacy Carve-Out (Cover) - March 2021
Patient-Centered Medical Home Model - November 2018
Advanced Primary Care Incentive Payment Program - November 2018
Patient-Centered Medical Home and Advanced Primary Care Incentive Payment Programs: Comprehensive Payment Policy and Billing Guidance - November 2018
Medicaid Managed Care Enrollees Service Authorization and Appeals Procedure Changes - March 2018
Medicaid Managed Care (MMC) and Children's Health Insurance Program (CHIP) Network Providers Must Enroll in the New York State Medicaid Program - January 2018
OMIG Webinar: Retroactive Disenrollment Notification Process - June 2017
Attention Managed Care Network Providers: Medicaid Provider Enrollment Requirement - May 2017
Update: Emergency Contraceptive Coverage - March 2017
Update on the Smoking Cessation Benefit in Medicaid Fee-for-Service and Medicaid Managed Care - March 2017
Attention Family Planning Providers: Medicaid-covered Long Acting Reversible Contraceptives - March 2017
New York State Medicaid Managed Care Pharmacy Benefit Information Website Update - June 2016
Behavioral Health Transition to Managed Care (Outside of New York City) – What Providers Need to Know - June 2016
New York State Medicaid Managed Care Pharmacy Benefit Information Website Update - September 2015
Nassau and Suffolk Counties to be included in Transportation Carve-out for Managed Care Enrollees - August 2015
New York State Medicaid Managed Care Pharmacy Benefit Information Website Update - May 2015
Transition of Nursing Home Benefit and Population into Mainstream Medicaid Managed Care - January 2015
Expansion of Medicaid Managed Care Covered Benefits to Include HIV Resistance - May 2014
New York State Medicaid Managed Care and Family Health Plus Pharmacy Benefit Information Website Update - March 2014
Nursing Home Population and Benefit Transition to Medicaid Managed Care - February 2014
Transition of Nursing Home Benefit and Population into Managed Care - January 2014
Hospice Services in Mainstream Medicaid Managed Care - September 2013
Medicaid Managed Care Mail Order Pharmacy Information for Retail Pharmacies - August 2013
New York State Medicaid Managed Care and FHPlus Pharmacy Benefit Information Website Update - July 2013
Standard PA Form in MMC/FHPlus and FFS - June 2013
Speciality Mail Order Pharmacy in MMC - June 2013
Expanding Prescriber Prevails in MMC in Certain Drug Classes - June 2013
Reminder: Hospice Services for Managed Care Enrollees - June 2013
Coverage of Residential Health Care Facility Services for Medicaid Managed Care Enrollees - March 2013
Prescriber Prevails in Medicaid Managed Care for Atypical Antipsychotics - December 2012
Instructions for Beneficiaries Enrolled in Medicare Managed Care Plans - November 2012
New York State Medicaid Managed Care and Family Health Plus Pharmacy Benefit Information Website - October 2012
Mandatory Medicaid Managed Care Expanding to Chemung County - October 2012
Reporting of the National Drug Code (NDC) - September 2012
Exclusive Pharmacy Network in Managed Care - September 2012
Transmission of the Official Prescription Serialized Number Update - September 2012
Transportation to be Carved-Out for Managed Care Enrollees in New York City - September 2012
Mandatory Medicaid Managed Care Expanding to Additional Counties - September 2012
Reporting of the National Drug Code (NDC) is now required for all Physician Administered Drugs for Medicaid Managed Care and Family Health Plus (FHPlus) Plans - August 2012
Mandatory Medicaid Managed Care Expanding To Wyoming County - July 2012
Written Orders Requirement for Preschool/School Supportive Health Services Program (SSHSP) - July 2012
Mandatory Medicaid Managed Care Expanding to Tioga County - May 2012
Orthodontic Services to be Included in the Medicaid Managed Care Benefit - April 2012
Dental Services to be Included in the Medicaid Managed Care Benefit page - April 2012
Mandatory Medicaid Managed Care Expanding To Schuyler and Steuben Counties - April 2012
Clarifying Information for Medicaid Fee-for-Service (FFS} and Managed Care Pharmacy Providers - March 2012
Beneficiaries with End Stage Renal Disease Must Enroll in Medicaid Managed Care - February 2012
Infants with Low Birth Weight and Infants with Disabilities under Six Months of Age in Medicaid Managed Care - February 2012
New Populations to Enroll in Medicaid Managed Care - February 2012
Medicaid Managed Care now available in Jefferson and St. Lawrence Counties - January 2011
Managed Care Covered Services - December 2010
Medicaid Managed Care Now Available in Lewis and Wyoming Counties - October 2010
Mandatory Medicaid Managed Care Expanding To Additional Counties - October 2010
Providers May Bill Medicaid Fee-For-Service for Family Planning & Reproductive Health Services Provided to Enrollees of Fidelis Care New York - May 2010
Billing for mental health clinic visits for SSI and SSI-related recipients - March 2010
Medicaid Beneficiaries Cannot Be Billed for the Cost of a Non-Related Transplant Donor Search - November 2009
Instructions for Beneficiaries Enrolled in Medicare Managed Care Plans - November 2009
State Health Department Designates Bariatric Surgery Centers for Medicaid in NYC - November 2009
NY Medicaid implements Preferred Diabetic Supply Program (PDSP) - October 2009
Intrauterine Devices (IUDs) for Managed Care Enrollees - September 2009
Behavioral Health Services for HIV+ Individuals Enrolled in Medicaid Managed Care in New York City - June 2009
Inpatient Directly Observed Therapy for Tuberculosis For Enrollees in Medicaid Managed Care - June 2009
Supervising/teaching physician documentation in the clinic setting - June 2009
Coverage of Viral Tropism Tests for Managed Care Enrollees - April 2009
Update on Mandatory Managed Care for SSI and SSI-related Medicaid Enrollees - November 2008
Family Health Plus Pharmacy Benefit - July 2008
Policy on "Interrupted Treatment" for Dental Procedures - June 2008
Reminder: Medicaid Enrollees Cannot be Billed - June 2008
Update on Mandatory Managed Care for SSI and SSI-Related Enrollees - May 2008
Article 28 Clinics: Revised Instructions for the Billing of Implanon and Intrauterine Devices - November 2007
Benefit Clarification for Intrauterine Devices - September 2007
Reminder: Medicaid Enrollees Cannot be Billed - July 2007
Medicaid Reimbursement for Implanon - June 2007
Medicaid Managed Care Disenrollment Process for Long Term Home Health Care Program Participant - February 2007
Medicaid Recipients with Medicare Managed Care (HMO/MCO) Coverage - January 2007
Ordered Ambulatory and Medicaid Managed Care Reimbursement for Intrauterine Devices - December 2006
Preferred Drug Program Implementation - July 2006
NYC Ordering Providers: Ordering Ambulette Service in New York City - June 2006
Enrollment and Coverage for Newborns - May 2006
Medicaid Recipients Cannot Be Billed - April 2006
Erectile Dysfunction Procedures Now Require Prior Approval - January 2006
Added Benefit for New York City Medicaid Managed Care Package - January 2006
Managed Care Plans: Dental Services for Enrollees - December 2005
Managed Care Enrollee Pharmacy Co-Payments Inadvertently Deducted - May 2005
Managed Care Benefit Clarification Concerning Coverage of Residential Health Care Facility Services - April 2005
Managed Care Enrollee Pharmacy Co-Payment Changes - March 2005
Expansion of Managed Care Special Needs Plans Service Areas - March 2005
Magnetic Media Processing Will Change in March 2005 - March 2005
Encounter Data Submission - March 2005
Managed Care Enrollee Pharmacy Co-Payment Changes - February 2005
eMedNY: Magnetic Media Processing Notification - January 2005
eMedNY: HMO Encounter Data Submission - December 2004
eMedNY Phase II: Magnetic Media Submissions - November 2004
Managed Care: New York City Special Needs Plans - October 2004
Mental Health And Chemical Dependence Providers - September 2004
Expansion Of Service Areas Managed Care Special Needs Plans - August 2004
Medicaid's Fee-For-Service Vision Care Policy - August 2004
NYC Providers Voluntary Medicaid Managed Care For SSI And SSI-Related Beneficiaries - June 2004
Managed Care Special Needs Plans Expansion Of Service Areas - February 2004
Expansion of Service Areas Managed Care Special Needs Plans - November 2003
Who Pays for Dental Services: Managed Care or Fee-For-Service? - November 2003
Enrollment of Newborns when Mom is in Medicaid Managed Care or Family Health Plus - October 2003
Usage of Exception Code 83 for Chemical Dependence Services - September 2003
New Managed Care Special Needs Plan in Manhattan - August 2003
Announcing Two New Managed Care Special Needs Plans - July 2003
Basis Of Payment for Durable Medical Equipment for Managed Care Recipients - July 2003
Billing for Newborns In Managed Care Plans - June 2003
New Managed Care Special Needs Plan in NYC - June 2003
Announcing a New Managed Care Special Needs Plan - May 2003
Medicaid Amends the Managed Care Benefit Package - February 2003
Providers in Oneida County and Surrounding Areas Update on Kids Oneida - December 2002
Section 5: Frequently Asked Questions about the Mandatory Generic Drug Program - October 2002
Managed Care Benefit Package Amended - September 2002
Clarification of Dental Services for Managed Care Enrollees - August 2002
Managed Care Changes For Alcohol & Substance Abuse Services - April 2002
Mandated Alcohol & Substance Abuse Services for Managed Care Enrollees - August 2001
All Medicaid Managed Care Enrollees have Coverage for Dental Services - March 2001
Medicaid Managed Care Enrollees Cannot Be Billed - March 2001
Attention: Mental Health Providers Serving Managed Care Recipients - January 2000
CSC Billing Bulletin - November 1999
Attention: Providers of Inpatient Substance Abuse Services - July 1999
Attention Pharmacists-Guaranteed Eligibility - June 1999
Managed Long Term Care Plans-System Modification - June 1999
All Providers - Managed Care Information - May 1999

Medicaid Management Information System (MMIS)

New York Medicaid Management Information System (NYMMIS) Update - December 2017
New York Medicaid Management Information System (NYMMIS) Continuous Improvements to Training - June 2016
New York Medicaid Management Information System (NYMMIS) Learning Management System and Computer-Based Trainings - May 2016
New York Medicaid Management Information System (NYMMIS) Training Update - April 2016
New Law in Relation to the Consumer Directed Personal Assistance Program (CDPAP) - March 2016
New York Medicaid Management Information System (NYMMIS) Current Courses and Computer-Based Trainings - February 2016
New York Medicaid Management Information System (NYMMIS) Training and Webinars - January 2016
NYMMIS - Webinar trainings are now available for the New York Medicaid Management Information System - December 2015
The New York Medicaid Management Information System (NYMMIS) Update - November 2015

Medicaid Prescriber Education Program

Addressing the Recent Fungal Meningitis Outbreak - December 2012

Medicaid Therapy Management (MTM)

Medicaid Therapy Management - April 2008

Medicaid Update

Retroactive Prior Authorization (PA) for Point-of-Service Medicaid Fee-for-Service Pharmacy Claims - August 2015
Medicaid and ICD-10 Implementation - February 2014
Medicaid Moving Toward ICD-10 Code Sets Implementation - October 2013
Medicaid Update newsletter will move to electronic distribution - November 2008
Medicaid Update newsletter will move to electronic distribution - October 2008
Do You Receive Multiple Copies of the Medicaid Update? - April 2008
Reminder: The Medicaid Update is Available Electronically! - January 2008
New York State Medicaid Online - January 2008
Missing Issues? - September 2007
The Medicaid Update is Available Electronically! - August 2007
Do you receive multiple copies of the Medicaid Update? - August 2007
Missing Issues? - July 2007
To All Medicaid Update Readers - March 2007
Would You Like to Receive the Medicaid Update Electronically? - September 2006
Medicaid Requires Providers to Stay Informed of Policy and Claiming Rules - September 2006
Medicaid Information Available Online - August 2006
Would You Like Future Medicaid Updates Emailed To You? - August 2005
Receive Electronic Copy of Medicaid Update - July 2005
Index of 2004 Medicaid Update Articles - March 2005
Would You Like Future Medicaid Updates Emailed to You? - March 2005
Would You Like Future Medicaid Updates Emailed To You? - February 2005
Would You Like the Medicaid Update Emailed to You? - December 2004
Provider Services - June 2004
Provider Services - May 2004
Provider Services - April 2004
Provider Services - March 2004
Do you ever wonder … Did I miss some important information in past Medicaid Updates? - December 2003
You can receive the Medicaid Update Electronically - November 2003
Payment of Medicare Coinsurance - November 2003
Medicaid to Change the Way it Distributes the Medicaid Update to Groups - October 2003
Reminder: You Can Request the Medicaid Update Electronically - July 2003
New Option For Receiving The Medicaid Update - May 2003

Medicaid Utilization Threshholds (MUTs)

Determining Utilization Threshold Status - February 2012
New York Medicaid to Cover Cardiac Rehabilitation for FFS Enrollees - December 2009
Computer Sciences Corporation Offers Seminars - Sign Up Today! - June 2008
New York City Ambulette and Livery Providers: Car Seat Policy Clarification - June 2008
Changes in the Medicaid Utilization Thresholds - April 2008
Seminar Schedule and Registration - September 2007
Computer Sciences Corporation Call Center Contact Information - August 2007
Accessing the Medicaid Eligibility Verification System - June 2007
ePACES Enrollment - January 2007
Claim Submission Methods (Correction to Article That Appeared in the March 2006 Edition) - April 2006
eMedNY Transition Plan Now Available - March 2005
Utilization Threshold Policy Reminders - July 2004
Claims Pending for Edits 01154 & 01155 - February 2001
Utilization Threshold Service Authorization Exception Codes & TOAs - July 2000
Utilization Threshold Program: Nurse Midwives Eligible to Submit TOAs - May 2000
Attention Physicians and Clinics: Important Notice Concerning Submission of Threshold Override Applications for Increases in UT Limits - August 1999

Medically Fragile Children (MFC)

Important Information for All Providers Serving Children (cover) - January 2021
Medically Fragile Children's Private Duty Nursing Providers Directory Goes Live (Cover) - October 2020

Medicare (Part not specified)

Medicare Advantage Supplemental Dental Insurance - December 2018
Medicaid Recipients with End Stage Renal Disease (New) Requirement to Apply for Medicare Benefits - November 2018
Medicare Providers May Not Bill QMBs for Medicare Cost-Sharing - May 2012
Policy & Billing Guidance from EPIC - Secondary Coverage for Medicare Part D - January 2011
2011 New York State Medicare Part D Prescription Drug Plans - October 2010
Eligibility/Benefit Verification for Beneficiaries Enrolled in Medicare Health Plans/Medicaid - June 2010
Fox Insurance Company of New York members now enrolled in Medicare LI-NET program - March 2010
NPI submitted on claims to Medicare must be enrolled with NY Medicaid - March 2010
Medicare Automated Claim Crossover Update - December 2009
2010 New York State Part D Medicare Prescription Drug Plans - December 2009
Point-of-Sale Facilitated Enrollment (POS FE) Process/Limited Income NET Program Announcement - November 2009
Medicare Crossover Update - November 2009
Second Notice: Medicaid to Implement Automated Medicare Crossover in December - October 2009
Medicare Parts B/D Coverage Flashpoints - September 2009
Medicare Reimbursement Guidelines - September 2009
Medicaid To Implement Automated Medicare Crossover in December 2009 - September 2009
Medicare Coverage of Immunosuppressant Drugs - April 2009
Facilitated Enrollment for Duals - February 2009
PART D Transition Supply Policy Reminder - February 2009
Wheeled Mobility Bases Enrollees - February 2009
2009 Medicare Prescription Drug Plan Listing - December 2008
Explanation of Medicare Benefits (EOMB) - December 2008
EPIC Update: New York's Prescription Program for Seniors - October 2008
Herpes Zoster Vaccine: Medicaid Reimbursement Policy When Medicare is the Primary Insurance - April 2008
Payment Error Measurement Rate Program Update: Request for Medicaid Provider Documentation - April 2008
Medicare/Medicaid Crossover - April 2008
Medicare Drug Coverage Under Part A, Part B and Part D - February 2008
Claims Pending Review for Edits 00127 and 01283 - February 2008
Medicare Part D Beneficiary Cost Sharing - January 2008
Wellpoint/Unicare Change in Point of Sale Facilitated Enrollment Process - December 2007
Transitioning to New Medicare Part D Drug Plans: How You Can Help - December 2007
Medicaid Wrap-Around Benefit for Dual Eligible Enrollees - December 2007
Coinsurance Enhancement for Psychiatrist Services - December 2007
Correct Billing for Medicare Part B Coinsurance on Non-HIPAA Compliant and Paper Claims - December 2007
Prescribers and Pharmacy Providers: Is Your Patient Covered by Medicare? - October 2007
Coverage of Immunosuppressant Drugs - July 2007
Pharmacists Must Bill Medicare First - June 2007
Medicare Coinsurance Claim Adjustments - May 2007
Your Provider Manual is Online - May 2007
Medicare Part B/D Coverage Flashpoints - March 2007
Medicare Part B Reimbursement - March 2007
2007 New York State Medicare Part D Prescription Drug Plans - February 2007
Medicare Part D Drug Plan Problems Formal Complaint Process - January 2007
Medicare Prescription Drug Benchmark Plans for 2007 - December 2006
Medicare Part D Drug Formulary Exceptions - December 2006
Approval of Darbepoetin Alfa (Aranesp) for Dialysis Patients - November 2006
Medicare Part B Coverage of the Influenza Vaccination - November 2006
Medicare Part B Drug Coverage/Billing Issues - November 2006
Medicare Part D Wrap-around Benefit Changes Starting January 1, 2007 - November 2006
Change Of Implementation Date For The New Medicaid Limited Wrap-around Benefit - August 2006
New Requirements for Gastric Bypass Surgery When Medicare is the Primary Payer - July 2006
Update on the Medicare Pharmacist Phone Line - July 2006
Wrap-around Coverage for Drugs Not Covered By a Medicare Part D Plan - July 2006
Preferred Drug Program Implementation - July 2006
Medicare Part D Prescription Drug Program - June 2006
Changes to the Medicaid "Wrap-Around" Program for Full Benefit Duals Enrolled in Medicare Part D2 - June 2006
Contact Information for Prescribers: Medicare Part D Listed below are contact numbers for the Medicare Part D benchmark Prescription Drug Plans (PDP) in NYS - May 2006
Letter from the Commissioner of Health - May 2006
New Phone Number - May 2006
Guidance for Prescribers and Pharmacists on Part B vs. Part D Drugs - May 2006
Transportation & DME Providers: Enrollment Requirements for Each Operating Location - February 2006
Medicare Part D: Benchmark Prescription Drug Plans - February 2006
Medicare Part D: Temporary Coverage of Pharmacy Claims - February 2006
Medicare Drug Coverage, Eligibility, and Co-Payments for Institutionalized Individuals - February 2006
Medicare Part D Drug Plan Information and Updates - February 2006
New Rate Codes for Nursing Home Billing - January 2006
Hospital Billing Changes - January 2006
Reimbursement to Nurse Practitioners and Midwives for Practitioner Office Laboratory - January 2006
Did You Know? The Medicare Prescription Drug Program will Cover Smoking Cessation Products Beginning January 1, 2006 - January 2006
All Providers: Billing Requirements for Recipients Who Have Other Insurance - December 2005
Billing Change for Xolair®(omalizumab) - December 2005
Medicare Part D Prescription Drug Benefit to Start January 1, 2006 - December 2005
Correct Billing For Medicare Part B Coinsurance - January 2005
Pharmacy Providers: You Must Bill Medicare First - January 2005
NCPDP 5.1: Billing Requirements for Medicare Crossover Claims - December 2004
Pharmacy Providers: Bill Medicare First - December 2004
Medicare Requirement for Pharmacy Enrollment in the Medicaid Program - December 2004
Medicare Part A is Purchased for Select Recipients - October 2004
Hospital Services Paid Off-line - October 2004
Pharmacy: Medicare, Medicaid, and EPIC - October 2004
Pharmacy Providers Reminder To Enroll In Medicare - August 2004
Physician Billing For Drugs - May 2004
Payment of Medicare Coinsurance - May 2004
Payment of Medicare Coinsurance - November 2003
Legislative Change Reduces Medicaid Payment for Medicare Coinsurance - August 2003
SNF Billing Medicare for Influenza & Pneumococcal Vaccinations - September 2000
Clarification to May 2000 Medicaid Update Article - August 2000
Prior Approval Submission Requirements - May 2000
Medicare Crossover Lawsuit - November 1999
Medicare Crossover Lawsuit - October 1999
Medicare Crossover Lawsuit - August 1999
Lawsuit Billing Information - August 1999
Medicare Crossover Lawsuit - May 1999
Medicare Crossover Lawsuit - February 1999
Medicare Crossover Lawsuit - January 1999

Medicare Card

Pre-Adjudication Editing Regarding the Medicare Beneficiary Identifier (MBI) - January 2020
Reminder: Medicare Card Replacement Initiative - November 2019
New Medicare Card Replacement Initiative: MBI to be Returned on Eligibility Response (cover) - September 2018
Reminder: The Medicare Beneficiary Identifier is Confidential and Should be Protected as Personally Identifiable Information - July 2018
New Medicare Card Replacement Initiative - February 2018

Medicare Crossover Claims

Medicare Part B

Important Message Regarding Medicare Part B Claims Submitted by Pharmacies (cover) - May 2018
Medicaid Fee-For-Service (FFS) Reimbursement of Medicare Part B Pharmacy Claims: Notification of Automatic Adjustments of Previously Paid Claims - July 2016
Medicaid Fee-For-Service (FFS) Reimbursement of Medicare Part B Pharmacy Claims - April 2016
Medicare Part B Providers Reminder - November 2015
Clarification on Medicaid Reimbursement of Medicare Part B Services Including Pharmacy Items (cover) - July 2015
Payment of Medicare Part B Coinsurance Will Change - December 2011

Medicare Part C

Medication

Medicaid Fee-for-Service Prescription Drug Coverage for "Emergency Services Only" Category of Eligibility - August 2016
Return of Unused Medications from Nursing Facilities - September 2006
Influenza Vaccine Information - December 2004
Nursing Homes and Pharmacies Guidelines for Unused Medication - August 2003
Are Your Patients Taking Their Medicine? - September 2002

Member Service Request

Transportation Management Initiative Covers All New York City Boroughs - September 2012
Transportation Management Initiative Covers Four New York City Boroughs - August 2012

Mental Health

Medicaid Coverage of Mental Health Counseling by LCSWs and LMSWs - June 2011
APG Methodology Replaces PCAP Rates - February 2010
DOH and OMH Partnering to Improve Psychotropic Prescribing In New York State - July 2009
Behavioral Health Services for HIV+ Individuals Enrolled in Medicaid Managed Care in New York City - June 2009
Web-Based Continuing Medical Education Courses Available for Psychotropic Prescribing - April 2009
Medicaid coverage for mental health counseling provided by LCSW/LMSW - March 2009
Update on Mandatory Managed Care for SSI and SSI-related Medicaid Enrollees - November 2008
Update on Mandatory Managed Care for SSI and SSI-Related Enrollees - May 2008
Minimum Reimbursement for Mental Health Clinics Licensed Solely Under Mental Hygiene Law - April 2008
Mandatory Managed Care for SSI and SSI-Related Medicaid Enrollees - January 2008
Coinsurance Enhancement for Psychiatrist Services - December 2007
Mental Health And Chemical Dependence Providers - September 2004
Expansion Of Service Areas Managed Care Special Needs Plans - August 2004
Payment for Psychiatric Social Work Services in Federally Qualified Health Centers - December 2003
Transitions: Mentally Ill Returning to the Community - February 2003

Metozolv ODT ® (metoclopramide orally disintegrating tablets)

Medicaid Pharmacy Prior Authorization Programs Update - February 2013

Midwives

Licensed Midwives as First Assistant at Cesarean Section Deliveries - May 2010
Changes to Medicaid fee-for-service reimbursement policy - March 2010
Billing instructions for physician administered drugs (J-codes) submitted on paper claims - December 2008
Increases in Practitioner Fees and Payment Enhancements - December 2008
Medicaid drug rebate program overview - October 2008
National Drug Code Required on Claims for Physician Administered Drugs - June 2008
National Drug Code Required on Medicaid Claims - December 2007
Sterilization and Hysterectomy Consent Forms Available Online - August 2007
Medicaid Reimbursement for Implanon - June 2007
National Drug Code Required on Medicaid Claims - June 2007
Ordered Ambulatory and Medicaid Managed Care Reimbursement for Intrauterine Devices - December 2006
Your Provider Manual is Going Online - October 2006
Reimbursement for Automated Urinalysis in a Practitioner's Office - September 2006
Reimbursement to Nurse Practitioners and Midwives for Practitioner Office Laboratory - January 2006
Sterilization and Hysterectomy Consent Form Request - November 2004
Medicaid Prescription Requirements - December 2003
Midwives and New Procedures - May 2002
You Need to Correct your Provider Manual - July 2001
Revised Medicaid Fee Schedules - May 2001
Office & Physician Speciality Fee Increases Effective October 1, 2000 - October 2000
Utilization Threshold Program: Nurse Midwives Eligible to Submit TOAs - May 2000

Money Follows the Person (MFP) Demonstration Program

Empowering Individuals through the Money Follows the Person (MFP) Demonstration Program - January 2016

Mosquito Repellent

Mosquito Repellent Coverage - September 2016