News Summary

  • Medicare Part D prescription drug copayment issue corrected

    04/12/2018 - Some Medicare Part D prescription drug copayments calculated incorrectly beginning January 1, 2018. As a result, certain IHCP members dually eligible for Medicaid and Medicare were asked to pay higher copayments for their prescriptions than should have been required. The Medicare Part D copayment issue has been corrected. Medicare Part D Plans will work with PBMs and pharmacies to ensure claim adjustments are made so that pharmacies and members are reimbursed appropriately.

  • Taxonomy codes for rendering providers not required on claims

    11/17/2017 - The IHCP reminds providers that taxonomy codes for rendering providers are not required on claims. If a taxonomy code for a rendering provider is submitted on a claim, the taxonomy code will not be validated. National Provider Identifiers (NPIs) for rendering providers are still required on all fee-for-service (FFS) and managed care claims.

  • IHCP implements taxonomy code requirement changes

    11/14/2017 - The IHCP will implement the changes to taxonomy code requirements for attending, operating, and OPR providers announced in BT201768, effective November 29, 2017. As stated in BT201768, these changes apply to all fee-for-service (FFS) and managed care claims, regardless of submission format, and are retroactive to dates of claim submission on or after February 13, 2017.

  • IHCP reminds providers how to interpret PA status information

    07/25/2017 - As stated in BR201715, PA status codes displayed on the Portal and used in the IVR comply with the HIPAA 278 transaction standards and provide only a high-level, standardized description of the actual working status of the PA request. To help providers, the IHCP has created a crosswalk table showing the standard response categories reported on the Portal and through the IVR with the administrative working statuses associated with each standard response category.