Requirement of ACA re Physician Enrollment Enforced

March 19, 2015

In the editied version of a December DMAS memo available here, you will see the relevant paragraph about the decision by DMAS to enforce a rule which has been in place since 2010.  There have been numerous memos and other attempts to educate the practitioners about the need for them to enroll with Medicaid if they are going to prescribe to Medicaid Members, and the implementation has been postponed several times. 

The requirement is now in place and as providers responsible, in many cases, for the health and welfare of the individuals we support, we need to also be informed.  Currently some of the pharmacies are absorbing the loss – but that won’t last for ever.  With a copy of the attached, you may be able to question each prescriber to assertain if they are properly enrolled.