This is a reminder that the Medicaid program prohibits enrolled providers from billing recipients for charges for COVID-19 protective measures, including sanitizing exam rooms and using personal protective equipment, such as masks, gowns, and gloves (collectively, “PPE”). Cost sharing for Medicaid fee-for-service and managed care members is limited to applicable copays based on federal rules, including New York’s Medicaid State Plan and 1115 Medicaid Redesign Team Waiver.
Billing Medicaid recipients for PPE is considered an “Unacceptable Practice” under Medicaid rules, which may result in provider sanctions up to and including termination from the Medicaid program.