Situation Report | November 22, 2021
Effective January 10, 2022, all Fee-for-Service (FFS) Medicaid Private Duty Nursing (PDN) requests, including those from Westchester County, will be reviewed and adjudicated by the Office of Health Insurance Program’s Bureau of Medical Review PDN Prior Approval Unit.
PDN Providers will continue to follow the current submission process outlined in the PDN Manual.
All new cases and renewals must be submitted by a Medicaid enrolled PDN provider (independent nurse or nursing agency) though ePACES or through the mail using a paper prior approval request form. Prior approval for all PDN services is required before the start of providing services.
For instructions on using ePACES or completing the paper prior approval form, review the manuals on the eMedNY website.
For information about enrolling in ePACES or questions about how to submit an electronic 278 prior approval, contact eMedNY at (800) 343-9000 or visit https://www.emedny.org for more information.
All providers with prior approval questions should contact the Bureau of Medical Review PDN Prior Approval Unit via email to: OHIPMEDPA@health.ny.gov or 1-800-342-3005.