News & Updates

12 Dec Maine Medicaid Provider Agreement

Visit Members Resources for information on coverage and services, transportation, telemedicine, primary care providers and more. Should I have a “Reassignment Statement” form signed for all employees and contract employees? No, only employees who are themselves registered as independent providers of Medicaid. Remember, the goal here is to make sure there is no double lawsuit against Medicaid. How are electronic signatures authorized by the service provider? DHHS has authorized the use of the edMS Electronic Signature Verification Form in Lumea. This form should be completed and registered annually. Can a school district bill be billed for contract providers? Yes, yes. A clarification provided by MaineCare in February 2012 confirmed that districts can charge contracts and employees. A “Reassignment Declaration” form should also be executed with contract agents who are also registered MaineCare service providers. For more explanations, see below. CCU provides Maine residents with simple and timely solutions for complex health, financing and investment issues through the integrated participation of suppliers and communities. Districts should also be aware that the Maine Department of Health and Human Services Program Integrity Unit has advised all MaineCare suppliers that they should also audit the Maine Excluded Supplier Database and the Federal Price Management System database. As a Medicaid service provider, the school district is responsible for verifying the LEIE list on behalf of all employees and contract agents for benefits from whom the District is seeking a Medicaid rebate. The Centers for Medicare and Medicaid (CMS) strongly recommends reviewing this list every month.

EDMS will support the borough free of charge to support this process on behalf of the districts we serve. School districts are responsible for checking additional exclusion lists. What is the “Reassignment Statement” form? Medicaid has a blanket ban that Medicaid providers reallocate payment for services. For example, if an occupational therapist is registered as a Medicaid provider, that OT cannot allocate payment for its services to another party. However, there are exceptions to the prohibition rule, in which case Medicaid payments can be made to 1) each practitioner`s employer; or 2) the organization in which the service is provided by the delegated practitioner. This is why the school district, as a Medicaid service provider, can claim reimbursement on behalf of its employees and contract agents, without violating the reassignment ban as long as the individual practitioner “reassigns” its payment to the school district. Good practice suggests that, in the event that the contract worker or agent is also a Medicaid provider, there is a signed form indicating that the contract employee has paid for services to the District and will not seek reimbursement for the same services. Although not expressly mandated by state law, the use of the “Reassignment Agreement” form will allow the borough to prove that it has taken steps to ensure that there will be no double claims from two Medicaid providers. EDMS provided a form for this purpose. Are EDMS Snapshots the only documents I need to mention for guidelines and regulations? No no. We create snapshots for a quick reference. However, the snapshot does not replace an in-depth reading and understanding of the corresponding sections of the MaineCare Benefits Manual.

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