EMed Insights, Easy Cost Efficient Businesses to Start

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 eMedNY is New York State's electronic Medicaid system, managed by the Department of Health. It facilitates provider enrollment, claims processing, and payment for Medicaid services. Providers must enroll through eMedNY to offer services to Medicaid beneficiaries.emedny.org+2emedny.org+2emedny.org+2New York State Department of Health

Below is an overview of the specified provider types, including program details, enrollment processes, and qualifications:

1. Child (Foster) Care Agency

  • Program Overview: Authorized childcare agencies provide health-related services to children in foster care under Medicaid.

  • Enrollment Requirements:

    • Must be authorized by the New York State Office of Children and Family Services.

    • Out-of-state providers must enroll in the New York State Medicaid Program to bill Medicaid. emedny.org

  • Qualifications:

2. Durable Medical Equipment (DME)

  • Program Overview: DME providers supply medical equipment to Medicaid beneficiaries.

  • Enrollment Requirements:

    • Must be enrolled in Medicare before applying for Medicaid enrollment.

    • Out-of-state providers should provide proof of contract supplier status. emedny.org

  • Qualifications:

    • Adoption of an effective compliance program pursuant to New York State Social Services Law section 363-d.emedny.org+1PPL First+1

3. Home Health Aide

4. Personal Care and Consumer Directed Personal Assistance Program (CDPAP)

5. Transportation

  • Program Overview: Provides non-emergency medical transportation to Medicaid enrollees.

  • Enrollment Requirements:

    • Providers must comply with requirements detailed in the Transportation Provider Policy Manual. emedny.org+1emedny.org+1

  • Qualifications:

    • Authorization by the local Department of Social Services or the Human Resources Administration in NYC. emedny.org

6. Doula

7. Assisted Living Program (ALP)

  • Program Overview: Offers housing and supportive services to individuals medically eligible for nursing home placement in a less intensive setting.emedny.org

  • Enrollment Requirements:

    • Providers must complete the Assisted Living Program Enrollment Form.

    • Services must be approved in advance by the local Department of Social Services. emedny.org

  • Qualifications:

    • Compliance with state regulations for assisted living facilities.

8. Personal Emergency Response System (PERS)

  • Program Overview: PERS providers offer devices that allow individuals to call for help in emergencies.

  • Enrollment Requirements:

    • Providers must complete the appropriate enrollment forms and comply with ownership change regulations. emedny.org

  • Qualifications:

General Medicaid Enrollment Process via eMedNY:

  1. Obtain a National Provider Identifier (NPI): Most providers must acquire an NPI from the National Plan and Provider Enumeration System (NPPES).emedny.org

  2. Submit Enrollment Application: Complete the NYS Medicaid Enrollment Application specific to your provider type.emedny.org+1emedny.org+1

  3. Provide Supporting Documentation: Include all necessary forms and documentation as specified for your provider type.

  4. Compliance Program: Implement an effective compliance program as required by New York State Social Services Law section 363-d. emedny.org+1PPL First+1

For detailed instructions and forms, visit the eMedNY Provider Enrollment page.

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