New York State Medicaid Update - January 2022 Volume 38 - Number 1

In this issue …

Information in gray boxes in this issue indicates material abridged but linked from the succinct interactive Portable Document Format (PDF) version.

New Provider Enrollment Portal Coming Soon to eMedNY

Beginning in Spring 2022, New York State (NYS) Medicaid practitioners will have access to a new Provider Enrollment Portal, developed by the NYS Department of Health (DOH) and the contracted fiscal agent responsible for eMedNY system. The portal will enable practitioners to perform numerous maintenance transactions using an easy online process and offer an alternative to the current paper enrollment process to reduce turnaround time by the elimination of the need for United States Postal Service (USPS) delivery. The portal will also assist in the accurate completion of forms and will provide step-by-step instructions to guide practitioners through the process. Some of the key features of the portal will include the ability to:

  • view personal provider file data in real time, including Electronic Transmitter Identification Numbers (ETINs);
  • submit address changes;
  • perform Drug Enforcement Administration (DEA) updates;
  • affiliate to groups;
  • add specialties such as medical, dental, etc.;
  • update electronic funds transfer (EFT) information; and
  • check the status of maintenance transactions.

Information on how to access the Provider Enrollment Portal, training sessions, future upgrades, and applications for new enrollment, revalidation as well as reinstatement, will be announced as information becomes available. Providers are encouraged to regularly visit the eMedNY website and subscribe to the eMedNY LISTSERV for updates and email alerts.

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NY State of Health Open Enrollment Period Extended as Federal Public Health Emergency Continues

The NY State of Health Open Enrollment Period for 2022 Qualified Health Plans (QHPs) will remain open to align with the recent announcement regarding the federal government Public Health Emergency (PHE) extension, effective January 16, 2022. To view the announcement, providers can refer to the Assistant Secretary for Preparedness and Response (ASPR) "Renewal of Determination That A Public Health Emergency Exists" web page.

NY State of Health, the Official Health Plan Marketplace (Marketplace), provides new and returning consumers many quality low-cost health insurance options with a choice of QHPs in every county and continues to offer expanded tax credit savings through the American Rescue Plan Act (ARPA). To learn more about ARPA, providers can visit the How NY State of Health Enrollees Benefit from the American Rescue Plan web page.

Extending the Open Enrollment Period for QHPs aligns with the coverage rules for public programs also administered through NY State of Health. New Yorkers need to enroll by February 15, 2022, for coverage starting March 1, 2022. NY State of Health has been a critical safety net during the COVID-19 PHE for people who have experienced income or job-based coverage loss. Between March 2020 and December 31, 2021, enrollment across Marketplace programs have surged, with more than 1.5 million additional New Yorkers enrolling in Medicaid, the Essential Plan, Child Health Plus, and QHPs. Enrollment in the Essential Plan, Medicaid and Child Health Plus is open year-round.

Consumers continue to have a choice of health plan options, which can be found on the NY State of Health "2022 Qualified Health Plan Map" web page, and can use the "NYS Provider and Health Plan Look-Up" tool, to search for preferred provider networks, including doctors and hospitals. Free enrollment assistance is provided to local communities throughout New York State (NYS) and can be located on the NY State of Health "Find a Broker/Navigator" search tool.

Individuals and families can enroll in a health plan through the NY State of Health website, by speaking with an enrollment assistor via the NY State of Health "Find a Broker/Navigator" search tool or by calling the Customer Service Center at (855) 355-5777, Monday through Friday from 8 a.m. to 8 p.m. and Saturdays from 9 a.m. to 1 p.m.

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Update to Fee-for-Service Reimbursement for Federally Qualified Health Center Claims After Third-Party Payers and Managed Care Visit and Revenue Reporting Requirements

This article notifies New York State (NYS) Medicaid fee-for-service (FFS) Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) of the updated eMedNY claims processing system for FFS FQHC claims being submitted to Medicaid for reimbursement after commercial insurance and/or Medicare claim adjudication. Additionally, this article notifies FQHCs of the Managed Care Visit and Revenue (MCVR) updated reporting requirements related to reimbursement received from third-party payers.

Medicaid FFS FQHC Prospective Payment System Reimbursement After Third-Party Payers

FQHC clinics are entitled under federal law to receive set minimum, all-inclusive Prospective Payment System (PPS) payments for all qualified threshold visits. The payment logic applies to all FFS claims when NYS Medicaid is the primary payer; it also applies to any claims when NYS Medicaid is the secondary or tertiary payer.

The eMedNY claims processing system logic is being updated to allow FQHCs and RHCs, currently reimbursed via the federal PPS payment rate, to be reimbursed for all claims submitted to NYS Medicaid after primary commercial insurance and/or straight Medicare (Medicare Part B), or Medicare Advantage Plan (Medicare Part C) adjunction. This will allow FQHCs and RHCs to be paid up to the full PPS rate after primary insurers´ claims adjudicate. FQHC and RHC clinics should continue to submit their claims to NYS Medicaid containing all the payment information received from any/all primary insurance companies. Once the eMedNY claims processing system changes have been operationalized, NYS Department of Health (DOH) will initiate queries of all PPS claims with service dates on and after January 1, 2022, to systematically identify claims that should have been paid higher amounts to reach full PPS rate. Those claims identified will automatically be retroactively reprocessed by pulling back the previous FFS payments, then paying the differences to the FQHCs and RHCs up to the full PPS rate.

FFS Claim Submission Update for Medicaid Managed Care (MMC) Supplemental Wrap Payments

Under federal law, NYS is required to make payments to FQHCs and RHCs to cover the difference between amounts paid to the FQHCs and RHCs by Medicaid Managed Care Organizations (MMCOs), FQHCs and RHCs cost-based rate (if higher). These supplemental "wraparound" payments are made directly from NYS to FQHCs and RHCs via FFS claim submission, using rate code "1609".

Effective January 1, 2022, FQHCs and RHCs should no longer report any commercial insurance payments on their Medicaid FFS supplemental wrap claim submissions. This change will ensure that FQHCs and RHCs receive complete supplemental wrap payment. This modification may subsequently impact FQHC wrap payment rate calculation moving forward, as detailed below.

MMC Visit and Revenue Report Rate Adjustment

The amount of each FQHC and RHC supplemental wrap payment rate is calculated on an annual basis, using the most current calendar year MCVR report. The MCVR report details the MMC visit and revenue data by MMC Plan as well as the weighted NYS Medicaid rate used in the wrap calculation. The FQHC and RHC MCVR report submission, described above, supplies the data used to calculate the average MMC payment. The MCVR report compares the calculated MMC average to the FQHC and RHC blended Medicaid rate for the period and identifies the net difference, if any, which would be the FQHC and RHC supplemental payment for the period, assuming all information is accurate.

Effective January 1, 2022, FQHC and RHC will be required to submit any/all payments received from commercial, third-party payment sources in the MCVR data to be included in their MMC rate calculations. The MCVR report has been revised to accommodate the reporting of any payment´s providers have received from commercial, third-party payment sources.

Questions and Additional Information:

  • FFS claim questions should be directed to the eMedNY Call Center at (800) 343-9000.
  • FFS coverage and policy questions should be directed to the Office of Health Insurance Programs (OHIP) Division of Program Development and Management (DPDM) by telephone at (518) 473-2160 or by email at FFSMedicaidPolicy@health.ny.gov.
  • Supplemental Payment Program questions should be directed to the Division of Finance and Rate Setting (DFRS) Bureau of Managed Care Reimbursement by email at bmcr@health.ny.gov.
  • MMC general coverage questions should be directed to OHIP Division of Health Plan Contracting and Oversight (DHPCO) by email at covques@health.ny.gov or by telephone at (518) 473-1134.
  • MMC reimbursement, billing, and/or documentation requirement questions should be directed to enrollee MMC Plans.
  • MMC Plan contact information can be found in the eMedNY New York State Medicaid Program Information for All Providers Managed Care Information document.

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Medicaid Fee-for-Service Guidance for Duchenne Muscular Dystrophy Drugs

New York State (NYS) Medicaid fee-for-service (FFS) and Medicaid Managed Care (MMC) will utilize criteria to determine coverage of the following antisense oligonucleotide drugs: AMONDYS 45™ (casimersen), EXONDYS 51™ (eteplirsen), VYONDYS 53™ (golodirsen), and VILTEPSO™ (viltolarsen), for members who have a diagnosis of Duchenne Muscular Dystrophy (DMD). The drugs in this therapeutic class will be available for members/enrollees that meet the criteria outlined below. This coverage policy is effective April 1, 2022 for both FFS and MMC.

NYS Medicaid Coverage Policy

In accordance with Food and Drug Administration (FDA) indications, NYS Medicaid will reimburse for a DMD drug when all the following criteria are met:

  • patient must have a diagnosis of DMD;
  • documentation of genetic testing must confirm the DMD gene mutation of the patient is amenable to exon 45, 51, or 53 skipping;
  • documentation must confirm a stable dose of corticosteroids prior to starting therapy or a documented reason not to be on corticosteroids;
  • documentation indicates kidney function testing prior to starting therapy (except for eteplirsen); and
  • patient is not concurrently being treated with another exon skipping therapy for DMD.

Billing:

FFS

Drug administration payment will be processed through the Ambulatory Patient Groups (APG) payment when administered in a clinical setting. The following documentation must be included with the claim:

  • Manufacturer invoice showing the acquisition cost of the drug, including all discounts, rebates, and incentives.
  • Documentation of the medication administration; and
  • Documentation of the criteria listed under the NYS Medicaid Coverage Policy section above.
MMC

MMC Plans are required to comply with the requirements in the MMC/Family Health Plus/ HIV Special Needs Plan Model Contract Section 10-2, which can be found on the NYS DOH "Information for Health Plans" web page, and must ensure that covered services are provided in sufficient amount, duration and scope to be reasonably expected to achieve the purpose for which services are furnished. A provider participating in MMC should check the health plan of the patient to determine the plan billing policy for DMD drugs.

Questions and Additional Information:

  • FFS claim questions should be directed to the eMedNY Call Center at (800) 343-9000.
  • FFS coverage and policy questions should be directed to the Office of Health Insurance Programs (OHIP) Division of Program Development and Management (DPDM) by telephone at (518) 473-2160 or by email at FFSMedicaidPolicy@health.ny.gov.
  • FFS Pharmacy coverage and policy questions should be directed to the Medicaid Pharmacy Policy Unit by telephone at (518) 486-3209 or by email at PPNO@health.ny.gov.
  • MMC general coverage questions should be directed to the OHIP, Division of Health Plan Contracting and Oversight (DHPCO) by email at covques@health.ny.gov or by telephone at (518) 473-1134.
  • MMC reimbursement, billing, and/or documentation requirement questions should be directed to enrollee MMC Plans.
  • MMC Plan contact information can be found in the eMedNY New York State Medicaid Program Information for All Providers Managed Care Information document.

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Update to New York State Medicaid Coverage of Continuous Glucose Monitors

Updates are highlighted in yellow

New York State (NYS) Medicaid fee-for-service (FFS) and Medicaid Managed Care (MMC), including Mainstream MMC Plans, HIV Special Needs Plans (HIV SNPs), and Health and Recovery Plans (HARPs), cover continuous glucose monitors (CGMs) for members who have diagnoses of type 1 diabetes when the members meet the criteria outlined in this policy. CGM coverage for members with type 1 diabetes was effective November 1, 2017 for FFS and January 1, 2018 for MMC. Effective April 1, 2022, Medicaid FFS and MMCs not already covering CGMs for enrollees with gestational or type 2 diabetes will begin CGM coverage, as outlined in this article.

Overview

CGM is a glucose monitoring technology that continuously measures and displays interstitial glucose levels. Alarms and alerts are used to notify members when their blood glucose level is exceeding or falling below specified thresholds. This information is used by members to self-manage their diabetes.

NYS Medicaid coverage for CGM may be available for members who are diagnosed with diabetes and meet all the following criteria:

  1. Member with a diagnosis of gestational diabetes, or
  2. Member with a diagnosis of type 1 or type 2 diabetes:
    • Member is under the care of an endocrinologist, or an enrolled Medicaid provider with experience in diabetes treatment, who orders the device.
    • Member is compliant with regular visits to review CGM data with their provider.
    • Member is on an insulin treatment plan that requires frequent adjustment of insulin dosing or an insulin pump.
    • Member or member caregiver can hear and view CGM alerts and respond appropriately.

This guidance is aligned with the NYS Medicaid Program´s criteria for external insulin pumps, which can be found in the eMedNY Durable Medical Equipment, Prosthetics, Orthotics, Supplies – Procedure Codes and Coverage Guidelines document.

Billing

FFS

If the device being dispensed is not found on the Preferred Diabetic Supply Program (PDSP) List, located on the Magellan Medicaid Administration "Preferred Diabetic Supply Program" web page, prior approval (PA) is required. For specific FFS billing instructions and provider communication, providers can refer to the eMedNY "DME Manual" web page. If the device is on the PDSP List, the member still needs to meet the above criteria. If the member does not meet these criteria, the provider must submit a PA request to Magellan Medicaid Administration by telephone at (877) 309-9493.

MMC Plan

Providers participating in MMC should check with the individual health plans to determine how each MMC Plan will implement this policy. Questions regarding MMC reimbursement and/or documentation requirements should be directed to the enrollees MMC Plan. For an MMC Plan directory, providers can refer to the NYS Medicaid Program Information for All Providers – Managed Care Information document.

Important Reminders:
  • Providers who´ve had a recent visit with their patient (within the last six months) should order a CGM only.
  • Prescribers should be actively monitoring their patients to ensure adherence to treatment plans. Diabetes education is strongly encouraged.
  • Providers must document CGM data in patients´ charts. All collected data should be used in clinical decisions.
  • Insulin pump replacement will be considered when medically necessary, outside of manufacturer´s warranty, and not for recent technology upgrades. Repairs will be funded if outside of manufacturer´s warranty and cost effective (< 50 percent of fee).
  • Ancillary devices (such as, but not limited to, phones, tablets, and personal computers) are not covered.
  • Providers should verify manufacturer´s age requirements for the CGM device ordered.
Questions and Additional Information:
  • FFS claim questions should be directed to the eMedNY Call Center at (800) 343-9000.
  • FFS coverage and policy questions should be directed to the Office of Health Insurance Programs (OHIP) Division of Program Development and Management (DPDM) by telephone at (518) 473-2160 or by email at FFSMedicaidPolicy@health.ny.gov.
  • FFS Pharmacy coverage and policy questions as well as questions on the PDSP should be directed to the Medicaid Pharmacy Policy Unit by telephone at (518) 486-3209 or by email at PPNO@health.ny.gov.
  • PA requests via the Pharmacy Benefit providers should be directed to the Magellan Clinical Call Center at (877) 309-9493.
  • Questions regarding CGM PA or Dispensing Validation System (DVS) authorization for Medicaid FFS members should be directed to the DME program at (800) 342-3005.
  • MMC general coverage questions should be directed to the OHIP, Division of Health Plan Contracting and Oversight by email at covquesy@health.ny.gov or by telephone at (518) 473-1134.
  • MMC reimbursement, billing, and/or documentation requirement questions should be directed to enrollee MMC Plans.
  • MMC Plan contact information can be found in the eMedNY New York State Medicaid Program Information for All Providers Managed Care Information document.

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Reminder: Pharmacy Dispensing Non-Patient Specific Orders

New York State (NYS) law and regulation allow some drugs (i.e., emergency contraception, Naloxone) to be dispensed to a patient without a patient-specific prescription or fiscal order from their practitioner. This is known as a non-patient specific order. A pharmacy, in compliance with NYS law and regulations, may dispense and submit a claim when the following all apply:

  • a Medicaid fee-for-service (FFS) or Medicaid Managed Care (MMC) member/enrollee specifically requests the item on the date of service;
  • a pharmacy submits one course of therapy with no refills; and
  • the drug item(s) are dispensed according to:
    • Food and Drug Administration (FDA) guidelines,
    • NYS laws, rules, and regulations, as well as,
    • Medicaid Policy

Medicaid FFS Billing Instructions

Providers should:

  1. enter a value of "5" in the Prescription Origin Code field 419-DJ to indicate pharmacy dispensing;
  2. enter a value of "99999999" in the Serial Number field 454-EK; and
  3. prescriber identification field 411-DB may be submitted blank.

MMC Plan Billing

For billing information regarding pharmacy dispensing for MMC members, providers must refer to the enrollee MMC Plans.

Questions and Additional Information:

  • FFS claim questions should be directed to the eMedNY Call Center at (800) 343-9000.
  • FFS Pharmacy coverage and policy questions should be directed to the Medicaid Pharmacy Policy Unit by telephone at (518) 486-3209 or by email at PPNO@health.ny.gov.
  • MMC general coverage questions should be directed to the OHIP Division of Health Plan Contracting and Oversight (DHPCO) by email at covques@health.ny.gov or by telephone at (518) 473-1134.
  • MMC reimbursement, billing, and/or documentation requirement questions should be directed to enrollee MMC Plans.
  • MMC Plan contact information can be found in the eMedNY New York State Medicaid Program Information for All Providers Managed Care Information document.

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Reminder: Newborn Eligibility and Billing Including Pharmacy Claim Processing

Infants born to a birthing individual enrolled in Medicaid fee-for-service (FFS) or Medicaid Managed Care (MMC) on the date of birth are automatically eligible for enrollment in Medicaid. This is previously stated in the Enrollment of Newborns When the Mother is Enrolled in a Medicaid Managed Care Plan or a Health and Recovery Plan article published in the September 2016 issue of the Medicaid Update, and the Medicaid Newborn Reporting and Billing Procedures for Hospitals in New York State article, published in the March 2021 issue of the Medicaid Update.

According to New York Social Services Law Article 5, Title 11, §366-g (found on the "New York State Legislature" web page, then select "SOS"), a hospital is required to report each live birth of a child born to an individual receiving medical assistance on the date of the birth to the State within five business days of the delivery. A Medicaid Client Identification Number (CIN) must be generated no later than 10 business days after the reported birth.

According to New York Social Services Law Article 5, Title 11, §366(4)(b), a pregnant individual eligible for medical assistance on any day of pregnancy will continue to be eligible for services through the end of the month in which the sixtieth day following the end of the pregnancy occurs. A child born to an individual eligible for and receiving medical assistance on the date of the child´s birth shall be deemed to have applied for medical assistance and to have been found eligible for such assistance on the date of such birth, remaining eligible for such assistance for a period of one year. The newborn will be enrolled in FFS or MMC based on the enrollment of the birthing individual except for newborns that receive comprehensive third-party health insurance (TPHI). The following table is for pharmacists to use when experiencing issues in claim processing for a newborn child with Medicaid coverage:

Birthing Individual Enrollment Status at Date of Birth Newborn Enrollment Status Contact Information for Issues
FFS FFS Contact FFS Eligibility and Enrollment at (518) 474-8887
MMC MMC Contact the birthing individual MMC Plan*
MMC Health and Recovery Plan (HARP) Corresponding mainstream MMC to HARP Contact the birthing individual MMC Plan*, corresponding with the birthing individuals HARP
MMC or HARP, but newborn receives TPHI FFS Contact FFS Eligibility and Enrollment at (518) 474-8887
Eligible for (but not enrolled in) Medicaid FFS or MMC at time of admission for delivery FFS Contact FFS Eligibility and Enrollment at (518) 474-8887

*Contact information for each MMC Plan can be found at the NYS MMC Pharmacy Benefit Information Center website.

A hospital should make every effort to provide the birthing individual parent and/or guardian with the newborn Medicaid CIN at time of discharge. A pharmacy provider filling a prescription for a newborn should bill the payor as outlined in the chart above regardless of presence of Medicaid Card. If the information for the newborn is not available, the pharmacist should contact FFS Eligibility and Enrollment at (518) 474-8887 or the enrollee MMC Plan for information on how to submit the claim and/or how to update the enrollee information to allow for claim adjudication.

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Clarification: Prescriptions Issued Under Collaborative Drug Therapy Management Protocols

New York State (NYS) Education Law §6801-a and the Regulations of the Commissioner §68.10 state that qualified pharmacists who are properly certified and registered with the State Education Department and employed, or otherwise affiliated, with an eligible facility may engage in Collaborative Drug Therapy Management (CDTM). A qualified pharmacist, pursuant to a required written agreement or protocol with a voluntarily participating physician, as well as in accordance with the policies, procedures, and protocols of the facility, may adjust or manage a drug regimen of a patient who is being treated by a voluntarily collaborating physician for a specific disease or associated disease state. Such adjustment or management by the CDTM pharmacist may include adjusting drug strength, frequency, or route of administration and, if specifically authorized in a written order or protocol, allowing substitution or selection of a drug which differs from that initially prescribed by the physician of the patient.

A prescription issued under a CDTM protocol for a Medicaid fee-for-service (FFS) member or Medicaid Managed Care (MMC) enrollees must contain the name of the collaborating physician with the collaborating physician submitted as the prescriber on the pharmacy claim. The collaborating physician must be a NYS Medicaid-enrolled provider. Any prescription adjusted or managed by a CDTM pharmacist for a consenting member/enrollee must contain the name of the collaborating physician and be submitted with the collaborating physician as the prescriber. These requirements pertain to an initial prescriptions as well as any resulting adjustment in accordance with the protocol authorized by the physician.

Information on how a provider can enroll in NYS Medicaid is available on the eMedNY "Provider Enrollment and Maintenance" web page. Additional information regarding CDTM practice is available on the NYS Education Department´s "Collaborative Drug Therapy Management (CDTM)" web page.

Questions and Additional Information:

  • FFS claim questions should be directed to the eMedNY Call Center at (800) 343-9000.
  • FFS coverage and policy questions should be directed to the Office of Health Insurance Programs (OHIP) Division of Program Development and Management (DPDM) by telephone at (518) 473-2160 or by email at FFSMedicaidPolicy@health.ny.gov.
  • FFS Pharmacy coverage and policy questions should be directed to the Medicaid Pharmacy Policy Unit by telephone at (518) 486-3209 or by email at PPNO@health.ny.gov.
  • MMC general coverage questions should be directed to the OHIP, Division of Health Plan Contracting and Oversight by email at covques@health.ny.gov or by telephone at (518) 473-1134.
  • MMC reimbursement, billing, and/or documentation requirement questions should be directed to enrollee MMC Plans.
  • MMC Plan contact information can be found in the eMedNY New York State Medicaid Program Information for All Providers Managed Care Information document.

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New York State Medicaid Fee-for-Service Program Pharmacists as Immunizers

In accordance with revised New York State (NYS) Education law, effective January 31, 2022, pharmacists certified to administer immunizations are authorized to administer to patients 18 years of age and older, as recommended by the Advisory Committee on Immunization Practices (ACIP) of the Center for Disease Control and Prevention (CDC). The following vaccines can now be obtained by NYS Medicaid members 18 years of age and older:

  • Coronavirus (COVID-19)
  • Hepatitis A
  • Hepatitis B
  • Herpes zoster (shingles)
  • Human papillomavirus
  • Influenza (two years of age and older)
  • Measles, mumps, and rubella
  • Meningococcal
  • Pneumococcal
  • Tetanus, diphtheria, and pertussis
  • Varicella

NYS Medicaid coverage policy and billing guidance for the administration of COVID-19 vaccines can be found on the NYS Department of Health (DOH) "New York State Medicaid Coverage Policy and Billing Guidance for the Administration of COVID-19 Vaccines" web page.

For more information, providers can refer to the New York State Medicaid Fee-for-Service Program: Pharmacists as Immunizers Fact Sheet. For guidance on origin code and serial number values required with claim submission, providers can refer to the Matching Origin Codes to Correct Prescription Serial Number in Medicaid Fee-for-Service article in the July 2020 issue of the Medicaid Update.

Instructions for Medicaid Managed Care Pharmacy Billing

Individual Medicaid Managed Care (MMC) Plans should be contacted for their specific reimbursement and billing guidance. Plan information can be found on the New York State Medicaid Managed Care (MMC) Pharmacy Benefit Information Center website.

  • Fee-for-service (FFS) billing questions should be directed to the eMedNY Call Center at (800) 343-9000.
  • Managed Care Organization (MCO) billing questions should be directed to the individual MMC Plan.
  • CDC vaccine and immunization information can be found on the CDC "Vaccines and Immunizations" web page. Providers should regularly visit the OTC and Supply Fee Schedule on the eMedNY "Pharmacy Provider Manual" web page for updates on all procedure codes for vaccines, within the New York State Medicaid Fee-for-Service Program Pharmacists as Immunizers Fact Sheet.

Questions and Additional Information:

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Kathy Hochul
Governor
State of New York

Mary T. Bassett, M.D., M.P.H.
Commissioner
New York State Department of Health

Brett R. Friedman
Acting Medicaid Director
Office of Health Insurance Programs

The Medicaid Update is a monthly publication of the New York State Department of Health.