We would like to take this opportunity to inform you that in accordance with NYS Department of Health regulations, Medicaid Managed Care and Children’s Health Insurance Program providers, who prescribe medication, must be enrolled with State Medicaid programs. Moreover, all Prescribers of Pharmaceutical regardless of contractual status with the Plan must be enrolled in the Medicaid FFS program as billing provider in order to continue to serve Medicaid Managed Care members.
The Medicaid provider enrollment process is to ensure appropriate and consistent screening of providers and improve program integrity. Practitioners may either enroll as a non–billing, ordering/Prescribing/Referring/Attending (OPRA) provider, or as a Medicaid billing provider. Business, Group Practice and Institutional provider types will be offered the option to enroll in Medicaid as a billing or non-billing (Managed Care Only) provider.
MetroPlus urges you to take immediate action to enroll/re-enroll in the Medicaid program. You may do by doing the following:
- Select your provider type and complete the appropriate revalidation application including all required information and documentation and submit the revalidation to:
eMedNY, PO Box 4603, Rensselaer, NY 12144-4603
Questions specific to this requirement and/or the active list of Medicaid FFS providers may be addressed to the Bureau of Provider Enrollment and Bureau of Managed Care Fiscal Oversight at [email protected] and [email protected]
Bureau of Managed Care Fiscal Oversight, Division of Health Plan Contracting & Oversight, New York State Department of Health, Office of Health Insurance Programs, One Commerce Plaza, Suite 1609, Albany, NY 12210, 518-474-5050
We ask that MetroPlus participating providers send us a copy of your Medicaid enrollment when you receive it. The information may be sent via email to [email protected] or via fax to 212-908-3691.
Thank you for your attention and cooperation with this important requirement.