This message is to inform you that your Medicaid claims, which were submitted by Public Consulting Group (PCG) on June 1, 2022, were not processed by Medicaid as expected. Although PCG submitted the claims prior to the submission deadline, Medicaid was unable to process claims in a timely manner given the volume of claims received this week. As a result, you will not receive your payment from Medicaid as expected in cycle 2337. Claims that were processed late by Medicaid will become part of cycle 2338 and all payable claims will be paid on June 29th. If you are a provider who remained on the accelerated schedule you should receive payment on June 13th. This cycle will also include all claims submitted and processed by Medicaid through June 8th, 2022.
We will keep you apprised of any changes or updates we may receive from Medicaid regarding future payments. If you have any additional questions, please contact us at 1 866 315 3747.
Effective July 1, 2022, New York State certified school psychologists will no longer be recognized as qualified personnel in the Early Intervention Program. The attached document explains the background for this change, implementation activities that must occur prior to July 1, 2022, and upcoming activities related to the addition of four new professions that will be recognized as qualified personnel in the Early Intervention Program. Please follow the link to view the document.
On December 29, 2021, Governor Hochul signed legislation (A.5339/S.5560A) that significantly changes the way claims for Early Intervention services will be processed and paid. The legislation establishes an Early Intervention Program (EIP) covered lives pool funded by an assessment on insurance plans. The EIP pool funding will offset the municipal and State share of EIP services not covered by Medicaid. EIP claims will no longer be billed to commercial insurance. Claims will continue to be billed to Medicaid for covered services and to municipal escrow for non-covered services. Please follow the link for more information, including an infographic, Q&A, Insurance Circular Letter, and Frequently Asked Questions (FAQs).
In accordance with Federal Law, Providers who received payments for Early Intervention Services in the 2021 calendar year should expect to receive a number of 1099 forms. Providers will receive a 1099 from New York State Department of Health via the State Fiscal Agent (SFA) for amounts from the State Escrow account in 2021, a 1099 from Medicaid, and a 1099 from each insurance company. Please follow the link for details.
The State Fiscal Agent, PCG, has identified an issue with some payers rejecting claims when the child’s or provider’s address does not contain a 9-digit zip code. Payers use the US Postal Service to verify all addresses, and often require the 9-digit zip code for verification. Please follow the link for more information on looking up a 9-digit zip code.