Medicaid Enrollment Requirement for Ordering, Referring, Prescribing (ORP), and Other Treating Providers

Effective July 1, 2016, any claim submitted without the required ORP or attending physician information, or submitted with information for a provider who is not enrolled with Medicaid, will deny and the provider will not receive reimbursement for services. Any physician, other practitioner or facility providing services to Medicaid clients based on an ORP/attending providers order, referral, or prescription, will not be paid for such items or services unless the enrollment process is completed for ORP, and their NPI (National Provider Identifier) is included on the claim submitted by the billing / pay-to / facility.