NY Medicaid: OPRA Provider Requirements and Impact on Pharmacies

The NYS Medicaid recently informed referring and servicing providers that, effective for services provided on and after October 1, 2013, claims will be denied if they include the NPI of non-enrolled ordering, prescribing, referring or attending provider (OPRA). Below we discuss some of the changes.

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I-STOP Registry Login Problems

Many of our clients have been unable to contact representatives of the Health Commerce System (HCS) to establish or resolve problems with their Prescription Monitoring Program Registry (Registry) log-in for compliance with the new I-STOP law. Recently, the Department of Health (DOH) commented on the delay.

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I-STOP for Pharmacists

New York’s Internet System for Tracking Over Prescribing (I-STOP) legislation that, among other things, mandates prescribing practitioners to consult with the prescription monitoring registry prior to prescribing a controlled substance, will go into effect on August 27, 2013. Below we discuss some of the I-STOP implications for pharmacists.

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Referring to DMEPOS Suppliers: The Competitive Bidding Program

Round 2 competitive bidding program (Program) went into effect as of July 1, 2013 in 91 Metropolitan Statistical Areas (MSAs). At the same time, Medicare began the national mail-order program for diabetic supplies. Below we discuss some of the features of the Program and what this may mean for DMEPOS suppliers and those healthcare providers who refer patients for durable medical equipment and supplies.

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7 Key Issues In Physician Employment Contracts

Whether you are considering full-time or part-time employment, a newly minted doctor leaving a residency program or a more seasoned practitioner joining a group practice, the following key aspects of an employment relationship should be considered before agreeing to any arrangement.

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New York’s New I-STOP Prescription Law

Provider Alert: New York has a series of drug prescription laws that impact medical and pharmaceutical providers. We highlight those provisions below in chronological order.

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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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NY Medicaid Updates Physician and Dental Procedure Codes & Manual

In the winding days of 2012, the New York State Medicaid announced code changes for physicians and nurse practitioners as well as code changes and changes to the policy manual for New York dentists participating in the Medicaid program. We discuss some of those changes in this article.

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