If you take Medicaid Managed Care - NEW Medicaid Enrollment Requirement Jan 1, 2018

Thursday, October 05, 2017 5:24 PM | Carol Burke (Administrator)
Effective January 1, 2018 – Federal law requires ALL Medicaid Managed Care and Children’s Health Insurance Program providers must enroll with the state Medicaid programs. “For example, if you currently participate in a network with a Medicaid managed care plan that provides services to, or orders, prescribes, or certifies eligibility for services for, individuals who are eligible for medical assistance, the physician must enroll with New York State Medicaid” (Source: DOH website). Several payers (Fidelis and MVP) have announced the requirement that providers submit the paperwork to NYS by December 1, 2017. 

If you need to enroll:

The Physician Enrollment Forms can be found here.

o   You can enroll as a billing or non-billing provider (EITHER satisfy the legal requirement)
o   Once you click on the form you need, the next screen will have the form and instructions

If you are unsure, or to confirm you are enrolled you can call 1-800-343-9000 or check the Enrolled Practitioners Search site: https://www.emedny.org/info/opra.aspx

Your office’s APPs will also need to enroll.  They have different forms that can be found here: Nurse Practitioners and Physician Assistants

Note: Enrollment in Medicaid FFS does not require providers to accept Medicaid FFS patients.

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