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Medicaid Expiration of Provisional Temporary Provider Enrollment

Medicaid expiration of provisional temporary provider enrollment

Pursuant to waivers issued under section 1135 of the Social Security Act, New York State Department of Health had offered provisional temporary provider enrollment during the COVID-19 public health emergency (PHE). However, the Department is required to terminate the enrollment of and cease payments to providers who are provisionally and temporarily enrolled unless the provider has submitted a full enrollment application that meets all requirements for Medicaid participation and that application has subsequently been reviewed and approved by the Department within six months after the federal PHE was lifted.

The PHE expired on May 11, 2023, and providers who are identified as being provisionally and temporarily enrolled will receive notice to complete the full enrollment process. To remain enrolled in the NYS Medicaid program, providers must complete the full enrollment process by November 11, 2023.

 If you fail to complete the full enrollment process by November 11th, the Department will terminate your temporary participation in the Medicaid program pursuant to the expiration of the waivers issued under section 1135 of the Social Security Act. You will also be removed from all Medicaid Managed Care (MMC) and Children’s Health Insurance Program (CHIP) networks that you participate in. You will be ineligible to receive reimbursement for services provided, or any services ordered, referred, prescribed, or attended by you, for any Medicaid fee-for-service, managed care, or CHIP enrollees on and after that date.

 If you have questions regarding this action, please contact the eMedNY Call Center at 800-343-9000.

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