Current News | 2004 | 2003 Medicaid Healthplan 270/271 Companion Guide v3.0 March 2007
Version 3.0 of the MPHI-ISG 270/271 Companion Document is now available for download. Updates reflect recent changes to the
Medicaid Eligibility Service.
» Back to Top Introducing Medicaid Providers to Medicare Drug Coverage September 2005
Beginning January 1, 2006, Medicare will include prescription drug
coverage as part of the Medicare Modernization Act (MMA).
Medicaid prescription
drug coverage ends December
31, 2005. It will be replaced by Medicare’s prescription drug coverage.
Your
most vulnerable patients—Michigan’s low-income elderly
and the disabled—could be without prescription drug coverage unless
they take action by December 31, 2005 and enroll in a plan.
To learn more about Medicare Drug Coverage, click
here.
» Back to Top Medicare Drug Coverage Online Learning Course Now Available September 2005
The Medicare Drug Coverage Online Learning course is ready to help
you and your colleagues understand how this pharmacy benefit change affects
Medicaid
and EPIC beneficiaries. Medicare's prescription drug coverage will
replace the Medicaid pharmacy benefit for Michigan's low-income elderly
and the
disabled. Your most vulnerable patients could be without prescription
drug coverage unless they take action and enroll in a plan by December
31, 2005.
Do you know how to explain to your patients what they must do
to maintain
their prescription drug coverage? This online learning program
will provide you with the information you need to help them. Click
here to go to Medicare
Drug Coverage Online Learning.
For an optimal online learning experience,
we recommend you access the course on a PC with the Windows XP
operating system, Internet Explorer browser 6.0 or higher, and Java Runtime
Environment 1.5.
» Back to Top Medicaid Healthplan 270/271 Eligibility
Testing to Begin August 2005
MDCH will begin testing real time 270/271 transactions will all health plans who desire such functionallity with the department.
This document addresses the exchange of Michigan Medicaid eligibility information with the Interactive Solutions Group (ISG) of Michigan Public Health Institute (MPHI).
In addition to specifications regarding the ASC X12N 004010X092A1 transactions and applicable MDCH requirements,
this document provides how to information, pertinent to communication and testing with MPHI-Interactive Solutions Group.
» Back to Top Pharmacy
Benefit Change to Affect Medicaid and EPIC Beneficiaries June 2005
Change is coming from Medicare and it will impact your Michigan Medicaid patients
that are disabled or elderly. Medicare’s new prescription drug program
is replacing Medicaid’s pharmacy benefit for the disabled, for low-income
adults over 65 years, and for EPIC (Elder Prescription Insurance Coverage) participants.
» Back to Top Medicare
to Provide Financial Help for People with Limited Resources June 2005
Medicare’s new drug coverage program provides substantial financial assistance
for Michigan’s dual eligible (Medicare and Medicaid) population and for
people with limited financial resources. Beginning May 27, Medicare, in cooperation
with Social Security, will begin mailing applications to provide extra financial
help to people with limited resources who are eligible for the new Medicare prescription
drug coverage program.
» Back to Top Subscribe
to E-mail Updates about Medicare Drug Coverage June 2005
Stay in touch with late breaking news and more information about Medicare Drug
Coverage.
By subscribing to the Trading Partners listserve, you will receive the latest
information in your e-mail about the new Medicare prescription drug program.
This information is a free service from Michigan Medicaid and the Michigan Department
of Community Health. We encourage all of our trading partners to subscribe, especially
pharmacists, doctors, and nurses.
» Back to Top MDCH Announces the End
of the HIPAA Contingency Period August 2004
With the announcement of the retirement of all non-HIPAA compliant
formats effective November 1, 2004, BCBSM and Medicaid will only
accept HIPAA compliant
formats and code sets.
Michigan Medicaid providers are well on their
way to achieving 100% HIPAA transaction compliance. MDCH has announced
three new steps to bring Medicaid providers into HIPAA transaction compliance:
For New Submitters Only:
Effective immediately, MDCH will only accept the three HIPAA
compliant electronic formats (837A1 Dental; 837A1 Institutional;
837A1 Professional) from new Medicaid
providers and new electronic billing agents.
For Current Submitters Only:
Effective November 1, 2004, MDCH will only accept the three
HIPAA compliant electronic formats (837A1 Dental; 837A1 Institutional;
837A1 Professional)
from current Medicaid submitters.
For All Electronic Submitters:
Effective January 2005, the HIPAA 835 Electronic Remittance
Advice will be the only electronic format available for receiving
payment/remittance data.
» Back to Top Medicaid to Begin Accepting Medicare Part B Crossover Claims from WPS July 2004
Professional billers will now be able to submit electronic claims
to Wisconsin Physician Services and have them automatically “cross over” to
Michigan Medicaid. This coordination of benefits will save substantial billing
time and expedite payment for dual eligible patients for both Medicaid and
Medicare.
It is essential that electronic billers convert to 4010A1 format and to
include their Medicaid Provider ID number in order for crossover claim
acceptance.
More detailed information can be found in both the Medicaid-Medicare
Crossover Claims FAQ and the MDCH
Bulletin (All Provider 04-05) located on the MDCH web site.
» Back to Top Begin Testing Electronic 835 Remittance May 2004
Michigan Medicaid is ready to send its new 835 electronic Remittance Advice (RA)
transactions to Medicaid providers or service bureaus as part of its commitment
to implement HIPAA transactions. The 835 electronically cross references claims
while providing detailed payment information. The 835 RA replaces Medicaid’s
proprietary electronic RA. Providers and their electronic submitters should begin
conducting 835 Business-to-Business (B2B) testing with Medicaid now.
To begin B2B testing, providers should:
1. Complete the Trading Partner Agreement
Go to https://tpa.mihealth.org or
call Trading Partner Support at 1-800-215-8765.
2. Choose a Unique Receiving Service Bureau (URSB)
Choose to partner with a URSB per tax identification number (TIN) and identify
it to Medicaid by its service bureau ID number. Call Karen Parker, manager of
the Provider Support unit, at (517) 335-5455 or via email at PARKERK@michigan.gov to
confirm your URSB.
3. Elect to Receive 835s–Contact the Testing Team
Contact Jim Kunz at kunzj@michigan.gov to
begin 835 B2B testing and elect to receive 835s from Medicaid. Providers and
their URSB should submit HIPAA compliant claims (837 v. 4010A1).
