News

• Medicaid Claims Readjudication Update for All Article 31 Mental Health Clinics (May 23, 2013) (448kb) – Please read the attached notice in its entirety.  It contains extremely important and time sensitive information for Article 31 clinic providers regarding the long-awaited readjudication of Medicaid fee-for-service claims with dates of service 10/1/10-12/31/11.  The process will begin with eMedNY cycle #1867.
  • OMH is planning to hold a webinar for providers in June to discuss any issues that may arise after the process begins.  Information on registration for the webinar will be posted here soon.

• Clinic Projection Tools have been updated (May 16, 2013)
  • The revised CPT Revenue Calculator reflects the 2013 CPT code changes and corrected diagnosis-based weights table.
  • The Procedure Weight and Rate Schedule has also been revised to reflect the 2013 CPT code changes and corrected diagnosis-based weights table.
• OMH Clinic Rates Codes
  These codes must be used for all services provided on or after January 1, 2012.
• Sample Clinic Encounter Form (114kb) – This form is not required. It was developed for clinics to use if they so choose.
• Letter to the Office of Medicaid Inspector General (OMIG) - Co-signed by OMH and New York State Department of Health (DOH) to OMIG
  • This letter in part temporarily waives the 90 days claims submission requirement and gives clinics 3 months from the date of federal Medicaid State Plan approval to adjust all claims and make any corrections as appropriate. The letter also requests that OMIG allow a time-limited moratorium on Article 31 clinic audits and disallowances.
  • Please note: When submitting claims more than 90 days from date of service during the period the waiver is in effect, clinics must enter reason code 3 (Authorized Delays - Delays previously approved). In addition, you should keep a copy of the attached letter in your files.

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Last Modified: 5/24/2013

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