Medicaid roundup: Changes in North Dakota, South Dakota

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Tuesday, April 30, 2019

The North Dakota House of Representatives and Senate have passed H.B. 1115, a bill that prevents the Medicaid program from requiring “prior authorization, additional documentation not required by Medicare or additional prescription requirements of DME and supplies to process a claim for Medicaid-eligible individuals who are also eligible for Medicare if any item has been paid by Medicare, unless the item is not covered by Medicaid,” according to MAMES. The legislature passed the bill after providers voiced concerns over the documentation requirements for Medicaid claims when Medicare is the primary payer…South Dakota’s Department of Social Services, Division of Medical Services, has announced that effective July 1 all incontinence supplies, including those through home and community based services waiver, will be routed through the Medicaid program as part of the DME and supplies benefit, according to MAMES. The announcement provides details on eligible individuals, service limits, codes included, reimbursement, physician order and CMN, and other bill details.