As previously announced in a provider alert dated June 28, 2022 Provider Alert, the Agency for Health Care Administration (Agency) has been implementing Referring, Ordering, Prescribing, and Attending (ROPA) requirements as directed by the 21st Century Cures Act (Cures Act) and by the Centers for Medicare and Medicaid Services (CMS). Previous provider alerts on National Provider Identifier (NPI) requirements for ROPA providers can be found on the Agency’s website in the Provider Message Archive. Providers must be enrolled with Florida Medicaid in accordance with Title 42, Code of Federal Regulations, Section 455.410(b).
All Fee-For-Service claims submitted January 1, 2023, or after from a non-exempt provider type that does not have a ROPA provider listed on the claim will be denied. The exempted provider types that will not require a ROPA on the claim are listed below, all other provider type claims must have a ROPA provider identified by NPI on the claim for reimbursement by Florida Medicaid.
In a provider alert dated June 28, 2022, the Agency previously set the effective date as October 1, 2022. To allow providers more time to prepare, we have extended the effective date to January 1, 2023. In addition, the Agency has continued to evaluate the effected provider types and has added several types to the exempted list.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.