Medicaid Payment Lag FAQ

  1. What is the benefit of lag removal?
    1. If providers are financially distressed, they can submit a request to the Department of Health to be temporarily removed from the Medicaid Payment Lag. This allows them to receive their reimbursement check for services provided two weeks earlier than regularly scheduled.  The suspension from the Medicaid Payment Lag is intended to be temporary.
  2. My approved suspension is about to expire, and I would like to request an extension to remain off the lag, how do I do that?
    1. Fill out the DOH Medicaid Payment Lag Exemption form online and submit the following documentation:
      • The latest available audited financial statements,
      • The latest available unaudited financial statements,
      • A monthly cash flow projection for the next 12 months,
      • Accounts Payable and Accounts Receivable with an aging analysis (template provided), and
      • Demonstration that the problem is a short-term problem caused by an extraordinary event or is related to issues with Medicaid and a projected date for reinstatement of the Medicaid Lag payment
  3. How do I know if my request has been approved or rejected?
    1. Once DOH has finalized the review process you will be notified via email by the ER/LAG mailbox administrator.
  4. How long can I remain off the lag?
    1. DOH approves lag exemptions up to one year. Providers that have been approved to be removed from the two-week lag are reevaluated by the Department of Health to determine if they should return to the normal two-week payment lag schedule. DOH staff will reach out to determine your financial status 30 days before your lag approval expires.
  5. Who do I call for questions/concerns regarding: billing, contact info, change of address or EFT/Check concerns
    1. Please visit www.eMedNY.org.
  6. What is an MMIS number
    1. The MMIS number is the 8-digit Medicaid Provider Identification number used in eMedNY to identify a provider.