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DOH Posts FAQs on Medicaid Enrollment Requirement

The Department of Health (DOH) has posted Frequently Asked Questions (FAQs) regarding the requirement that health care providers who contract with managed care plans enroll in Medicaid and obtain a Medicaid provider number. This applies to Licensed Home Care Services Agencies (LHCSAs), even though they don’t bill Medicaid directly. To view the recent FAQs posted by DOH, click here.

As a reminder, the 21st Century Cures Act requires all Medicaid Managed Care (MMC) providers to be enrolled with State Medicaid programs no later than Jan. 1, 2018. Providers can still enroll if they haven’t already. If you received a letter from your Managed Care Organization stating that you have been identified as a provider who is not actively enrolled with the New York State Medicaid program and are providing services to their Medicaid-eligible members, you must enroll, or you will be removed from their MMC provider network. The Medicaid provider enrollment process is to ensure appropriate and consistent screening of providers and improve program integrity.

To enroll, you will need to go to the Provider Index on the eMedNY website and navigate to your provider type to print and review the instructions and enrollment form. Here, you will also find a Provider Enrollment Guide and How Do I Do It? resource guide. Click here for Useful Links, which include FAQs and additional information related to the MMC network provider enrollment in New York State Medicaid.

Contact: Meg Carr Everett, meverett@leadingageny.org, 518-867-8871