Obstetricians and gynecologists (OB/GYNs) enrolled as Mississippi Medicaid providers are eligible for higher payments for certain services. In order to receive those enhanced payments they must complete the required form attesting that they qualify as specialists in those fields.
The Mississippi Division of Medicaid (DOM) will continue to reimburse at 100 percent of the Medicare Physician Fee Schedule for certain primary care services provided by OB/GYNs who self-attest as having at least one of four primary specialty/subspecialty designations in obstetric/gynecologic medicine as long as authorized by Miss. Code Ann. §§ 43-13-117, 43-13-121.
To begin receiving those enhanced reimbursements, eligible providers who have never attested before must self-attest. Eligible providers who have self-attested previously must re-attest. Eligible providers can attest by returning a completed and signed self-attestation form by June 30, 2017. Detailed instructions can be found below:
Pursuant to Miss. Code Ann. §§ 43-13-117, 43-13-121, DOM was granted the authority to continue reimbursing eligible providers at 100 percent of the Medicare Physician Fee Schedule for certain primary care Evaluation and Management (E&M) and Vaccine Administration codes. Effective July 1, 2016, and in accordance with House Bill (HB) 1560, DOM began reimbursing eligible OB/GYNs at 100 percent of the Medicare Physician Fee Schedule for certain primary care services. Eligible OB/GYNs must attest to one of the following:
- Physician is board certified by the American Congress of Obstetricians and Gynecologists (ACOG) as a specialist or subspecialist in obstetric/gynecologic medicine, or
- Physician with a primary specialty/subspecialty designation in obstetric/gynecologic medicine and has furnished certain primary care E&M and Vaccine Administration codes that equal at least 60 percent of the Medicaid codes they have billed during the most recently completed calendar year but does not have an ACOG certification, or
- Physician, newly enrolled as a Medicaid provider, with a primary specialty/subspecialty designation in obstetric/gynecologic medicine and attests that certain primary care E&M and Vaccine Administration codes will equal at least 60 percent of the Medicaid codes they will bill during the attestation period, or
- Non-physician practitioner providing primary care services in a Practice Agreement with a qualified physician enrolled for increased primary care services.
Pursuant to HB 1510, providers who self-attest to a specialty designation in obstetric/gynecologic medicine by ACOG will be eligible to continue receiving an increased payment for certain primary care services effective July 1, 2017. The DOM Primary Care Provider Fee Schedule is updated July 1 of each year based on 100 percent of the Medicare Physician Fee Schedule, which takes effect Jan. 1 of each year.
How to attest: Providers who have previously attested
To receive the increased payment for dates of service (DOS) beginning 7/1/2017, eligible providers who have previously attested must re-attest to continue receiving the payment.
How to attest: Providers who have NOT previously attested
Providers who have not attested before and meet the qualifications can attest for the period 7/1/2017-6/30/2018. Providers can attest by sending a completed and signed 7/1/2017-6/30/2018 OB/GYN PCP Self-Attestation form to Conduent Provider Enrollment by 6/30/2017.
Providers, whose forms are received after 5/31/2017 may experience a delay in the effective date of the increased payment. To receive the increased payment, eligible providers must send a completed and signed 7/1/2017-6/30/2018 OB/GYN PCP Self-Attestation form to Conduent Provider Enrollment through one of the following means:
- Email: firstname.lastname@example.org
- Fax: 888-495-8169
- Postal mail: Conduent Provider Enrollment, P. O. Box 23078, Jackson, MS 39225
Qualified providers who attest to a specialty designation in family medicine, general internal medicine, pediatric medicine or a subspecialty recognized by the American Board of Medical Specialties (ABMS), the American Board of Physician Specialties (ABPS), and the American Osteopathic Association (AOA) may be eligible for increased payment of certain primary care E&M and Vaccine Administration codes. Providers may submit a 7/1/2016-6/30/2018 Self-Attestation Statement form to Conduent Provider Enrollment and will be eligible to receive the increased payment effective the day the form is processed by Conduent.
Additional information can be found on the DOM website (medicaid.ms.gov), including the OB/GYN PCP Self-Attestation General Instructions, the 7/1/2017-6/30/2018 OB/GYN PCP Self-Attestation form, the PCP Self-Attestation General Instructions and the 7/1/2016-6/30/2018 Self-Attestation Statement form. Visit the Forms webpage.
Providers may also find this information on the Envision Web Portal (www.ms-medicaid.com/msenvision/) or it can be requested by calling the Conduent Call Center toll-free at 800-884-3222.
If you have questions, contact the Office of Medical Services by phone 601-359-6150.