Effective immediately, Mr. William Hamilton has been designated as the contact for all fair hearing matters on behalf of the Office of Medicaid Management (OMM) for medical and dental prior approval issues. Previously, two agency designations (HSM1 and HSM2) were utilized to code OMM prior approval issues. HSM1 generated notification to Vincent Martiniano on all prior approval issues other than dental, and HSM2 generated notification to Ms. Lori Siemian for all dental prior approval issues. Since Mr. Hamilton will handle both dental and non-dental issues, there is no longer a need to utilize the HSM2 agency designation. All prior approval and prior authorization issues should, therefore, be coded as follows:
Agency: LDSS/HSM1 (Upstate)
NMAP/HSM1 (NYC)
Category: MA
Subcategory: OHSM
Action: DISC/RED/INAD/DEN
Issue Code: 241, 242, 243, 244, 247, 269
This will generate notification to the:
Bureau of Medical Review & Evaluation
New York State Department of Health
Atten: Mr. William Hamilton
99 Washington Avenue, Suite 800
Albany, New York 12210-2808
Telephone: (518) 474-8161
Fax: (518) 474-9760
This transmittal supersedes Transmittal Number OAH 97-18.
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