OB Providers: Check Your Status!
If you are a Family Physician who provides obstetrical care to Medicaid patients or you plan to enroll as a Medicaid provider – please be aware!
Recently the IAFP was alerted to the fact that Family Physicians have been erroneously dropped from MDwise's and MHS's lists of obstetrical care providers. The Family Medicine Residency Program that brought this issue to the IAFP's attention saw many of their faculty have their obstetric provider classification removed by the Managed Care Organizations without the Residency Program's knowledge.
The IAFP believes it would be wise for all Family Physicians who wish to provide obstetric care to MHS and MDwise Medicaid enrollees to double check their status and ensure they are listed as an OB provider.
If you think you have been dropped from the OB provider list of MHS you can contact Nancy Robinson at 1-800-944-9661 extension 20180 or by email at email@example.com. She will take care of ensuring you are on or added back to their list of OB providers.
If you think you have been dropped from the OB provider list of MDwise you can contact Chris Kern at 317-822-7220 or by email at firstname.lastname@example.org. He will take care of ensuring you are on or added back to their list of OB providers.
The root of the error was found to be MDwise’s and MHS’s interpretation of the new Hoosier Healthwise, HIP and Care Select Provider Enrollment Form (see the full form here). MDwise and MHS enrollment specialists failed to recognize family physicians as providers of obstetrical care unless they checked a box within the “scope of practice” section of the form.
However the form’s wording is confusing and seems to instruct Family Physicians to skip the section entitled “scope of practice” (see form excerpt from page 2 of the form below).
Both MDwise and MHS have informed the IAFP that Family Physicians who provide obstetrical care should check the "all women" box in the scope of practice section of the enrollment form, even though the instructions say they cannot.
At the request of the IAFP and IAFP members Chris Kern, a provider relations manager at MDwise, has asked the Indiana Office of Medicaid Policy and Planning to adopt changes to the Hoosier Healthwise, HIP and Care Select Provider Enrollment Form. Both MDwise and MHS support changing the form to clarify where on the form family physicians should indicate they provide obstetrical care.
Anthem Medicaid claims they have not had similar issues. Please take note that they do not want family physicians using the “scope of practice section” on the Hoosier Healthwise, HIP, and Care Select Provider Enrollment Form. Anthem interprets this box as for OB/GYN specialty physicians only. Anthem’s enrollment specialists look at other portions of the form (such as delivery privileges) to determine whether a family physician provides obstetrical care.