Discontinuation of Preadmission/Preprocedure Review Program (200406)

FROM: Theodore O. Will, Chief Executive Officer
DATE: Sep 30, 2004
SUBJECT: DISCONTINUATION OF PREADMISSION/PREPROCEDURE REVIEW PROGRAM
IPRO CONTACTS:

Doreen Walz, Medicaid Review Operations, Ext. 444


Please be advised that effective October 1, 2004 the New York State Department of Health will no longer require prior approval for procedures reimbursed through the Products of Ambulatory Surgery (PAS).

Accordingly, on October 1, 2004 calls will not have to be made to the IPRO for prior authorization precertification number (800) 624-2554, for approval to perform an outpatient procedure in the ambulatory surgery setting, or ambulatory surgery procedure in the inpatient setting on or after this date.

The New York State Department of Health will continue to monitor claims for unusual activity, and if necessary, will conduct sample selection for retrospective review in the future.

Should you have any questions regarding the above, please contact Doreen Walz, Assistant Director at extension 444.