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Preschool/School Supportive Health Services Program

2015 News/Announcements

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SSHSP News/Announcements

Medicaid Alert #15-04 Clarification of Timely Signatures/Co-signature for “Under the Direction of” (UDO) and “Under the Supervision of” (USO) • Service documentation is required to be completed in a “contemporaneous” manner by Medicaid, which

means as close to the conclusion of the session as practicable.

• For services provided September 1, 2015 and thereafter, attending provider responsible for UDO/USO must sign/date service encounter documentation no more than 45 (calendar) days following the date of service.

• Districts and counties may have a shorter signature/co-signature timeframe policy.

Refer to Medicaid Alert #15-04 for more detailed information.

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SSHSP News/Announcements

ICD-10 Coding (International Classification of Diseases-Tenth Revision)

• ICD-10 is an expanded code set.• Claims for dates of service on and after October 1, 2015 require ICD-10 codes.• eMedNY will not publish an ICD-9 to ICD-10 crosswalk: Use the many resources available

through https://www.emedny.org/icd to explore your options.• All billing providers who bill Medicaid are impacted: See the FAQs on the eMedNY website to

see how your NY Medicaid claims will need to be submitted.• ICD-9 and ICD-10 codes are not allowed within the same claim.• Possible interruption in payment: Submitting claims with ICD-9 codes for dates of services

on and after October 1 will be rejected by pre-adjudication edits.

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Medical Orders and Referrals Best Practices

• Do not alter an order that has been signed and dated.• Additional information, or clarifications received should be attached.

• Example: The ordering or attending professional needed to be contacted to translate the ICD-9 to an ICD-10 code; do not write this on the order – attach it on a separate piece of paper

• Required information that is missing from the order can not be added; return the document for the item(s) to be added and re-signed/dated, or obtain a new order.

• See p.21-22 of SSHSP Handbook Update #8 for required elements of an order/referral.

SSHSP News/Announcements

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Reminders

• Medicaid providers (including SSHSP providers) must complete the revalidation process to continue to bill Medicaid (federal requirement).

• There is an annual (December) recertification of Compliance Plans with OMIG for those with claiming activity over $500,000/year.

• Parental Consent - “Notification Regarding Use of Public Benefits” letter must be sent annually.

• Keep ETIN current for billing through CNYRIC.• Contact RIC representative for “onboarding” training for new staff assigned to SSHSP

responsibilities (Medicaid 101).• Affiliate new attending provider NPIs before claiming.

SSHSP News/Announcements

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Resources: Medicaid-In-Education Website

http://www.oms.nysed.gov/medicaid/

• Medicaid Handbook Update #8• Questions and Answers (1 - 227)• Medicaid Alerts• Training PowerPoints• Training Handouts• Certified Public Expenditures• Parental Consent

Sign up on the LISTSERV – Get updates automatically.

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Resources: Support Services

Regional Information Centers (RICs)

• Medicaid 101 Training

• Documentation Training

• Direct support • http

://www.oms.nysed.gov/medicaid/contacts/ric_contacts.html

Random Moment Time Study (RMTS) and Annual Cost Reporting:

• PCG Hotline: 866-912-2974• NYSSHSP@pcgus.com

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Resources: Compliance Officer

Robert Jake LoCicero, Esq. Deputy Director of Administration NYS Department of Health Corning Tower – Room 2863 Albany, New York 12237 Telephone: (518) 474-9868

9Resources: State Contacts

NYS DOH - SSHSP Medicaid Policy and Medicaid Claiming QuestionsDOH 518-473-2160DOH SSHSP Mailbox: SSHSP@health.ny.gov

SED - Provider Support and Training SED 518-474-7116 SED Mailbox: medined@nysed.gov