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Site Updates

July 3, 2009 Due to a problem with a process modification regarding the mailing of remittance checks, some providers will experience a delay in the receipt of their weekly Medicaid check. Claims remittance checks should be received by Monday July 6th or Tuesday July 7th. We have taken the necessary steps to ensure that this problem does not occur in the future. We apologize for any inconvenience this may have caused you. Neville Wise, Director Division of Administration and Financial Management Department for Medicaid Services July 3, 2009 Public Notification Revised from May 26, 2009 Notification Revised (PDF) Notification Revised (Excel) June 18, 2009 Per CMS, current Medicaid policy does not allow providers to bill recipients for missed appointments. In no case may a provider impose charges upon a Medicaid recipient for a missed appointment. May 26, 2009 Information regarding Excluded Providers On January 16, 2009, the Centers for Medicare and Medicaid Services issues a letter to state Medicaid Directors to reiterate a long standing policy. The letter clarifies the federal statutory and regulatory prohibitions regarding providers who have been excluded from participation in Federal Health Care programs. For more information please review the following letters. KY Medicaid General provider Letter regarding excluding providers CMS Letter regarding excluding Providers You may also visit the Office of the Inspector General Exclusions Program website for the List of Excluded Individuals/Entities DMS List of Excluded Providers Click the Excluded/termed provider list March 9, 2009 As you are aware, The American Reinvestment and Recovery Act (commonly referred to as the Economic Stimulus Bill), included some provisions that are meant to strengthen and increase the current Federal requirements for prompt pay of clean claims (clean claims will be finalized no later than 30 days from date of receipt). Although the Kentucky Medicaid program was and continues to be in compliance with prompt pay requirements (clean claims), we have elected to speed up claims payment timeframes to further ensure that we fully meet the new Prompt Pay requirements. Effective with the March 6, 2009 payment cycle, we are reducing the Prudent Pay (Cash Management) days from 19 to 15 days. This means that any of your adjudicated (paid status) claims that are equal to or greater than 15 days old each Friday, based upon receipt date, will be released. This speed up could result in a larger payment this week, but after the initial increase payments should return to normal levels in subsequent weeks based upon the 15 days. Kentucky Medicaid will continue to keep the provider community informed of any other changes that may be necessary due to the American Reinvestment and Recovery Act (commonly referred to as the Economic Stimulus Bill). January 26, 2009 If you are accessing KyHealthNET, there may be two remittance advices to select, 01/23/2009 and/or 01/26/2009. Due to cycle issues, several claims were not completed and it was necessary to run another cycle. You may be receiving this remittance advice as an addition to the RA from the Jan. 23, 2009 cycle. January 6, 2009 Changes to KY Medicaid: Providers Should not be Impacted Since 2005, First Health (FH) has served as the administrative agent for KY Medicaid, enrolling and credentialing providers, making updates and changes to already-enrolled provider files, hosting workshops for providers and more. As of Jan. 1, 2009, the Department for Medicaid Services will assume provider enrollment and credentialing responsibilities. View the new Web site. September 24, 2008 On September 29, 2008, Providers will be able to submit Crossover claims through KYHealthnet without a Medicare EOMB. Providers will find the new coding sheet for Professional Cross-overs by clicking on the Provider Relations link on the left, then click on Forms, then click on Provider Relations, the CMS1500 Crossover Coding Form is at the top of the list of provider forms. Important Information for Kentucky Medicaid Providers Announcement: Policy Clarification for Tamper Resistant Prescription Pads (TRPPP) May 9, 2008 May 14 is Legacy Free Day – an opportunity to check your National Provider Identifier (NPI) readiness. The Department for Medicaid Services (DMS) is requesting providers and their billing vendors to participate in a one-day NPI preparation exercise on Wednesday, May 14, 2008. Participating Kentucky Medicaid providers will send Medicaid claims with NPI-only in provider fields which originally contain NPI/legacy pairs from the provider. In other words, you or your billing vendor will strip the legacy identifiers when they are submitted as part of an NPI/legacy pair. Over the past month, Kentucky Medicaid has asked providers to begin testing NPI-only by sending a group of claims with NPI alone in primary provider fields. This exercise will help Kentucky Medicaid providers evaluate their NPI readiness prior to the May 23, 2008 deadline. The outcomes of this exercise are described below: Claims are processed and paid by Kentucky Medicaid. Under this scenario, the provider can feel confident that his or her cash flow will not be affected by the May 23 implementation date; or Claims are rejected or suspended. Under this scenario, the provider will know in advance that there are problems that must be resolved prior to May 23. Resolution might include changes to the NPESS data or to the Kentucky Medicaid provider enrollment record. On May 15, participating providers and their billing vendors can revert back to billing claims with their NPI/legacy pairs. However, if you have the NPI and taxonomy on file with Kentucky Medicaid, continue to bill claims with the NPI. Got Questions? Need More Information? Still not sure what an NPI is and how you can get it, share it? Click to view the Frequently Asked questions regarding NPI registration. Providers may also contact First Health at (800) 639-5195. Still not sure how to submit claims with your NPI? Providers may also refer to the Provider Billing Instructions or contact Provider Relations at (800) 807-1232 or the EDI helpdesk at (800) 205-4696 April 9, 2008 Announcement: Policy Clarification for Tamper Resistant Prescription Pads (TRPPP) The April 1, 2008 implementation of the tamper-resistant prescription pad requirements for written prescriptions billed to Medicaid has been successful thus far. However, there are policy clarifications that seem appropriate based on the questions received thus far. To view the clarifications, click the Policy Clarification for Tamper Resistant Prescription Pads. Tuesday, October 17, 2006 Provider Enrollment information and forms may now be found on the KyHealth Choices Web site. Wednesday, October 11, 2006 Starting in the Spring of 2007, all Medicaid members will receive a new card. For more information, click here. October 4, 2006 Provider Letter # A-10 - KyHealth Choices - Prior Authorization Requirements for Chiropractic Services (10/03/06) Effective October 1, 2006, Prior Authorization will not be required for KyHealth Choices. Chiropractic services for both children and adults. October 2006. October 2, 2006 Information regarding the new CMS 1500 Claim Form to be accepted beginning October 2006. September 14, 2006 Prior authorization requirements for KyHealth Choices have changed. Please access the DMS website to view the changes for radiology, speech therapy and physical therapy. August 11, 2006 KyHealth Choices - Prior Authorization Requirements A-70.doc ( 08/10/06) Frequently Asked Questions for the "Prior Authorization" Provider Letter Dated July 14, 2006 ( 07/31/06) To help expedite prior authorization requests, see KyHealth Choices - Prior Authorization Information ( 08/02/06) Includes: KyHealth Choices - Kentucky Medicaid Program Update (07/14/06) - Information on new prior authorization requirements and the DMS Communication Resource Guide; KyHealth Choices Prior Authorization Call Checklist (08/02/06) - Instructions and interactive response prompts about your prior authorization requests; and Radiology Services that Require Prior Authorization (08/01/06). Thank you for your attention to this announcement