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MA FFS Issues
August 16, 2010

Electronic Prescribing Available
The Department of Public Welfare (DPW) reminds providers that beginning August 16 electronic prescribing is available to prescribers (physicians, certified registered nurse practitioners, optometrists, dentists, podiatrists, and certified nurse midwives) enrolled in the Medical Assistance (MA) Fee-for-Service (FFS) delivery system. Providers can prescribe electronically using either electronic medical record (EMR) software or stand-alone Point-of-Care (POC) ePrescribing software. The EMR or POC ePrescribing software must be certified by Surescripts. Providers can determine software certification status by visiting the Surescripts web site. For more information access MA Bulletin 03-10-19, Electronic Prescribing for Providers That Have ePrescribing Software. Later this year Internet-based ePrescribing will be available through the PROMISe provider portal to enable prescribers who do not have EMR or POC ePrescribing software to prescribe electronically.

Billing for Missed Appointments
DPW has learned that some providers continue to bill MA recipients for missed appointments and requested that the following information be distributed. A MA bulletin on this topic is under development, but providers are reminded that there is long-standing policy that prohibits providers from billing MA recipients for missed appointments. According to a May 11, 1994 letter from Bruce Vladeck, then administrator of the Department of Health and Human Services, the policy is rooted in requirements that MA pay only for reimbursable MA services. “A missed appointment is not a distinct reimbursable Medicaid service, but a part of providers’ overall costs of doing business. The Medicaid rate covers the cost of doing business, and providers may not impose separate charges on recipients.” A copy of the letter and an earlier Medicaid director memorandum on the same topic are available by contacting Betty Simmonds.

Security Requirements for Provider Portal Cause Delays
Staff of the Office of Medical Assistance Programs report that providers may encounter problems with the Provider Portal due to security requirements. An example was given of providers being locked from access after three login attempts were not successful when the individual could not respond correctly to the security question. Providers that encounter this problem should contact HP, the software vendor. The HP Enterprise Services, Provider Assistance Center can be reached at 800-248-2152.

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