Important Information for Kentucky Medicaid Providers
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
Attention Providers: May 23 is only about three weeks away. Are you prepared? Do you have questions?
May 6, 2008
Providers, if you have questions about filing and sharing your NPI with KY Medicaid, please see the list of Frequently Asked questions about registration.
Attention Providers: May 23 is only 4 weeks away. Are you prepared?
April 28, 2008
The Department for Medicaid Services reminds providers and their billing vendors that the National Provider Identifier (NPI) and the taxonomy must be obtained, on file and used in claims submission before the end of the contingency date, May 22, 2008. Since NPI is a Centers for Medicare and Medicaid Services mandate that has been in effect since May 23, 2007, DMS chose to allow providers a contingency period.
Claims received by EDS for processing submitted with both the NPI and legacy provider number or just a legacy provider number will deny effective May 23, 2008.
Note: The NPI is the only value acceptable in any provider ID field on a claim, effective May 23, 2008. A taxonomy should also be submitted along with the NPI on the claim, in the case where a provider has registered one NPI with DMS but has enrolled and is billing claims for multiple provider types.
Providers enrolled as Hands, Commission for Handicapped Children, Title V, First Steps, Impact Plus and Non-emergency Transportation are considered atypical providers and are not required to submit an NPI and taxonomy on the claim. Atypical providers will continue to submit the legacy provider number.
To verify whether you or your billing vendor needs or is using an NPI, or would like to learn how you or your billing vendor can obtain, file and use an NPI, refer to the following Web sites for more information
Announcement - Policy Clarification for Tamper Resistant Prescription Pads (TRPP)
April 8, 2008
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. To view the clarifications, click the Policy Clarification for Tamper Resistant Prescription Pads.
Announcement - Tamper-resistant Prescription Pads Requirements effective April 1
Friday, March 21
Effective April 1, Medicaid will require all written prescriptions for outpatient drugs, including over-the-counter drugs, to be on tamper-resistant prescription pads. As you may recall, Congress mandated the new requirement last year, but temporarily postponed implementation until April 1 to allow more time for states to respond.
For more information about the tamper-resistant pads, click on the General Provider Letter #A-80 - Tamper-resistant Prescription Pads Requirements Effective April 01, 2008.
Announcement - Medicaid Claims Payment Cycle upcoming Changes Effective April 4
Friday, March 14.
This announcement is to advise providers of upcoming changes in the current Medicaid claims payment cycle.
For more information, click on the General Provider Letter # A-79 - Medicaid Claims Payment Cycle - Upcoming Changes Effective April 4, 2008 outlining the changes.
Announcement- New NDC "Brown Bagging" List Form is now available
Monday, Feb. 11:
The NDC Brown Bag List Form is now available on the DMS Web site. To view a copy of this form, refer to the Physician Services page.
Announcement - NDC to HCPCS Crosswalk Codes are now available
Monday, Jan. 28:
The NDC to HCPCS crosswalk codes are now available on the DMS Web site. To view a copy of the codes, refer to the Physician Services page.
Announcement - Kentucky Medicaid Receives Federal Approval for New Waiver
Tuesday, Feb. 26
Program Will Allow State to Serve Individuals with Brain Injuries in Community Settings
Kentucky's Medicaid program has received approval from the Centers for Medicare and Medicaid Services (CMS) to start a new waiver program to better serve individuals with acquired brain injuries in community settings.
The waiver will serve Kentucky residents age 18 and older with acquired brain injuries (ABI). It provides an alternative to institutional care for individuals who have reached a plateau in their rehabilitation level, and require maintenance services to avoid institutionalization and live safely in the community.
This new long term care waiver will complete the continuum of care by complementing Kentucky's existing ABI waiver program, which focuses on intensive rehabilitation services. The waiver also provides the option for self direction of services.
Plans call for Medicaid to roll out the new waiver services later this year.