OAAPN and Ohio GAPNA are pleased to announce that Ohio Medicaid has officially issued the Medicaid directive that eliminates the January 1st Dual Eligible policy that eliminated the Medicaid share of payment for APRN visits with beneficiaries who are eligible for Medicaid and Medicare coverage (dual eligible). You were recently notified of OAAPN and GAPNA’s successful efforts to have this policy rescinded.

The MHTL (Medicaid Handbook Transmittal Letter No. 3334-14-02) was issued on April 30, 2014 and is posted below for your convenience. Medicaid clarifies on page two that the term “physician services” which includes: a doctor of medicine or osteopathy, a doctor of dental surgery or dental medicine, a doctor of podiatric medicine, a doctor of optometry and a chiropractor, was amended to add certified registered nurse anesthetists ( CRNA), certified nurse midwives, clinical nurse specialists, and nurse practitioners. These APRN providers were initially excluded from the definition of “physician services” and are now included and therefore qualify for the Medicaid cross-over payment .

The new policy is effective April 30th and retroactive to January 1st. Ohio Medicaid recommends that providers who seek to adjust claims issued from January 1st through April 30th, access information on claim adjustment at http://www.Medicaid.ohio.gov.

We are seeking more detail on claim adjustments and will notify you as soon as we have additional information. OAAPN and Ohio GAPNA are working for Ohio APRNs, be sure to keep your membership up to date!

For more information, contact:
Christine Williams, christinewilliams01@gmail.com Ohio Association of Advanced Practice Nurses
Sandy Jorgensen, npeldercare@yahoo.com Ohio Gerontological Advanced Practice Nurses Association