Pediatricians, We Need Your Help!

It has come to the Payment and Practice Division’s attention that Medicaid will only allow and reimburse in-office nebulizer treatments once per month. DOH has advised they are willing to re-look at this policy but has asked for some supporting information. Please answer the 4 questions below and send your answers to [email protected]. with the subject line Medicaid Nebulizer Limitation Questionnaire. Please send the email encrypted as the CIN is particular to patients.

  1. Are these children typically having asthmatic episodes due to product availability issues of maintenance inhalers?
  2. Other than availability of maintenance inhalers, what factors contribute to the need for multiple in-office nebulizer treatments in a given month?
  3. Are you experiencing this during certain times of the year i.e., times where Upper Respiratory Infections (viral and bacterial) are of higher incidence?
  4. Can you provide any member CINs to demonstrate the more global problem (i.e., so we can confirm pharmacy claims for maintenance meds?)

If you have any questions or concerns, contact Heather Lopez.

Categories: PulsePublished On: February 29th, 2024Tags: , ,

Share