12/03/2015

Reminder to All Medicare Part B Providers

Pursuant to 2015 changes to Social Services Law, the NYS Department of Health is revising the Medicaid reimbursement methodology for claims containing Medicare Part B services/supplies. Effective January 1, 2016, Medicaid will no longer reimburse partial Medicare Part B coinsurance amounts when the Medicare payment exceeds the Medicaid fee or rate for that service. This change is retroactive to July 1, 2015 and applies to Medicare Part B services.

Additional information is also contained in the July 2015 Medicaid Update article entitled, Clarification on Medicaid Reimbursement of Medicare Part B Services Including Pharmacy Items.