Effective 10-1-21: Medicaid Claims will Deny if Referring, Ordering, Prescribing, and Attending Providers are Not Enrolled
 
Effective October 1, 2021, Florida Medicaid Claims will Deny if Referring, Ordering, Prescribing, and Attending Providers (ROPA) are Not Enrolled. 
The ROPA does NOT have to be Medicaid participating, only enrolled as a ROPA.
 
Link to: Frequently Asked Questions
 
 
 
FLORIDA MEDICAID
A Division of the Agency for Health Care Administration


Florida Medicaid Health Care Alert


Provider Type(s): All
Effective 10-1-21: Claims will Deny if Referring, Ordering, Prescribing, and Attending Providers are Not Enrolled


Effective October 1, 2021, any fee-for-service (FFS) claim submitted with a National Provider Identifier (NPI) for a provider not enrolled with Florida Medicaid will deny, and the provider will not receive reimbursement for services. This includes claims that list a Referring, Ordering, Prescribing, or Attending (ROPA) provider. ROPA providers must be enrolled with Florida Medicaid in accordance with Title 42, Code of Federal Regulations, Section 455.410(b).


Starting October 1, 2021, claims will not pay for any practitioner, group practice, facility, or pharmacy providing services to Florida Medicaid recipients based on a ROPA provider’s referral, order, prescription, or attending services, unless the ROPA provider identified by NPI on the FFS claim is actively enrolled with Florida Medicaid.
 
Florida Medicaid features a quick and easy, automated ROPA provider enrollment application on the Florida Medicaid Web Portal Enrollment Application Wizard page.


Link to: Complete Article
Link to:  Enrollment Application Wizard
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