Plans of Safe Care: Supporting Pregnant Patients Living with Substance Use Disorders-Provider Alert: Prescriber Enrollment Requirement

Provider Alert: Prescriber Enrollment Requirement

Pdf Summary

Starting July 1, 2024, Medicaid in Maryland will deny pharmacy claims without the National Provider Identifier (NPI) of an enrolled prescribing practitioner per federal regulations. All prescribers treating Medicaid patients must enroll by April 15, 2024, or risk claim denials. Enrollment can be as a full provider or an Ordering, Referring, and Prescribing (ORP)-only provider. Providers are urged to verify enrollment status and enroll via the ePREP Portal. Organizations should inform practitioners and assist with enrollment. This change does not affect billing procedures for behavioral health practices, such as Outpatient Mental Health Clinics (OMHCs). An informational hotline and online resources are available for assistance with the enrollment process. For more details and specific information on enrollment policies, contact mdh.rxenroll@maryland.gov.

Keywords

Medicaid in Maryland

pharmacy claims

National Provider Identifier

enrolled prescribing practitioner

federal regulations

Medicaid patients

Ordering, Referring, and Prescribing

ePREP Portal

behavioral health practices

Outpatient Mental Health Clinics