Non-Billing Ordering Providers Must Be Enrolled In Medicaid

New York State Medicaid Program posted new applications on April 1, 2013 for non-billing providers that order, prescribe, and/or refer beneficiaries with fee-for-service Medicaid coverage. New Jersey Medicaid required all such providers to be enrolled an “non-billing” providers by Jan. 1, 2013.

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Private Contracts With Medicaid Beneficiaries

Most providers know that fees paid by the New York State Medicaid program are considered to be payment in full. This means that as a requirement of participating with Medicaid, and with the exception of co-payments, providers may not bill Medicaid beneficiaries for covered services. Providers may, however, enter into private pay agreement with Medicaid beneficiaries and the article below addresses certain important aspects of that relationship.

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Get To Know New Jersey Medicaid Auditors

The New Jersey Medicaid and New Jersey FamilyCare programs insures more than one million New Jersey residents. Review responsibilities of the different units within the Medicaid Fraud Division, the State’s “watchdog” agency over these programs.

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New York Medicaid Program Prohibits Billing Beneficiaries

When a provider participates in the New York State Medicaid Program, a provider agrees to accept payment as payment in full for the provided services. The same applies to providers who accept Medicaid Managed Care or Family Health Plus (FHPlus) plans.

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New York to Reduce All Medicaid Payments to Docs by 2%

The final 2011-12 New York State budget (Chapter 59 of the Laws of 2011) requires a 2% across the board reduction to most Medicaid payments for dates of service on or after April 1, 2011. The reduction will remain in effect for dates of service through March 31, 2013. These provisions were enacted to meet

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