Under AHCCCS' News & Events web page, recent information was updated by AHCCCS regarding the Referring, Ordering, Prescribing, Attending (ROPA) program for providers who do not bill Medicaid. Mercy Care would like to pass this information along to our provider network:
AHCCCS Providers Who Do Not Bill Medicaid Will Be Able to Use a Streamlined Registration Application This Fall
All health care providers who refer AHCCCS members for an item or service, who order non-physician services for members, who prescribe medications to members, and who attend/certify medical necessity for services and/or who take primary responsibility for members’ medical care must be registered as AHCCCS providers. AHCCCS calls this initiative, and these providers, "ROPA.”
Federal ROPA requirements stipulate that any provider (with some exceptions) who serves Medicaid beneficiaries must register with AHCCCS.
To make the ROPA registration process as simple as possible, AHCCCS will develop a streamlined application for ROPA providers who meet all of the following criteria:
- Have a National Provider Identifier (NPI) from the National Plan and Provider Enumeration System (NPPES),
- Already fully enrolled in Medicare or another state’s Medicaid program, and
- Do not intend to bill AHCCCS for services.
The streamlined registration application is expected to be available in late 2022. Following that implementation, claims that originate from an un-registered ROPA provider will not be reimbursed.
Some providers, such as residents and interns, are exempt from this ROPA registration requirement. AHCCCS publishes a list of exempted providers on the AHCCCS ROPA web page and updates the list regularly.
Historically, referring, ordering, prescribing, and attending providers were required to obtain and maintain a National Provider Identifier (NPI), but were not required to be registered as an AHCCCS provider.
For additional information about ROPA, visit the AHCCCS ROPA web page.
As always, don't hesitate to contact your Mercy Care Network Management Representative with any questions or comments. You can find this notice and all other provider notices on our Mercy Care website. We appreciate your participation in our network and your dedication to the health and welfare of our members and your patients.
Thanks for all you do!
