Urgent Provider Information

Maricopa Health Plan (MHP) has received considerable feedback from the provider community regarding non-stress tests (NST), and routine and specialized ultrasounds. These items are currently included in our Total OB package.

We are pleased to announce that beginning with dates of service January 1, 2012; MHP will reimburse ultrasounds and non-stress tests separately from the Total OB package.

The below items will be excluded from OB package and reimbursed separately:
• Initial, Routine Ultrasounds for size and date
• Biophysical Profiles
• Non Stress Tests
• Complex Ultrasounds

Please contact your provider representative with any questions you may have.

TOB_Prior_Authorization_NOP_Form.pdf TOB_Prior_Authorization_NOP_Instruction_Form.pdf

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Click here to view the 2010 Fraud & Abuse presentation from the Arizona Office of Inspector General at AHCCCS. We encourage all provider staff to view this presentation.

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Important reminder, as a registered provider with the AHCCCS Administration, (Arizona's Medicaid Program), you are obligated under 42 C.F.R. §1001.1901(b), to screen all employees, contractors, and/or subcontractors to determine whether any of them have been excluded from participation in Federal health care programs. You can search the HHS-OIG website, at no cost, by the names of any individuals or entities. The database is called LEIE, and can be accessed at http://www.oig.hhs.gov/fraud/exclusions.asp

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