Medicaid Update – December 2024

The Office of Health Insurance Programs of the New York State Department of Health has approved the release of the December 2024 Medicaid Update. Please find the improved, interactive issue as a PDF (Portable Document Format) file available to be downloaded at: https://health.ny.gov/health_care/medicaid/program/update/2024/docs/mu_no13_dec24.pdf. A print-ready version is also available on the Medicaid Update web page.

You may also go straight to an article or topic that pertains to you by selecting from the current issue’s table of contents below.

Policy and Billing

1. New York State Medicaid No Longer Accepts Paper Claims for Medicare Health Maintenance Organization (Medicare Advantage or Part C) Copayment and Coinsurance Charges (Cover)
2. Reminder: Upcoming Changes to Billing Requirements for New York State Medicaid Fee-for-Service Professional Drug Claims
3. Increase in Reimbursement for Article 28 Clinic Providers Delivering Mental Health Services
4. eConsult Expansion: New Reimbursement in an Outpatient Setting
5. Updated Medicaid Practitioner Claiming Requirements for Sterilizations and Hysterectomies for Medicare Health Maintenance Organization (HMO) Enrollees
6. Ambulatory Patient Group Base Rate Enhancement for Article 28 Providers Serving Individuals with Intellectual, Developmental, and Physical Disabilities
7. Timely Postpartum Visit Incentive
8. Homeless Healthcare Services
9. New York State Medicaid Telehealth Policy Manual Update

All Providers

1. National Core Indicators Aging and Disabilities Adult Consumer Survey
2. New York State Medicaid Evidence Based Benefit Review Advisory Committee Update
3. Health Homes Added to List of Eligible Providers for New York State Medicaid Community Health Worker Services
4. Reminder: Referrals for Applied Behavior Analysis

Pharmacy

1. Pharmacy Updates to New York State Medicaid Coverage of Coronavirus Disease 2019 and Public Readiness and Emergency Preparedness Act Services
2. Billing and Eligibility Verification Reminders for Pharmacies

NYSHFA | NYSCAL CONTACTS:

Carl J. Pucci
Financial Consultant
518-462-4800 x36