Attention Pharmacy Providers: Service Restoration Office Hours with fb88Care Pharmacy Benefit​

fb88Care is inviting you to join the next  call with the fb88Care Pharmacy team on Thursday, April 25, 2024, from 09:00 AM – 9:45 AM related to the initial restoration of fb88 Point of Purchase System (MEPOPS). We will use this time as an opportunity for sharing questions and concerns and providing technical support from the State.  

Please register in advance for this meeting: 

Attaching an Explanation of Benefits (EOB) to Secondary Claims

When billing fb88Care secondary claims, you must attach an EOBA to all claims regardless of the submission type listed below:

  • Direct Data Entry (DDE)
  • Paper
  • Electronic Data Interchange (EDI)

When submitting electronically, upload the EOB once the claim is in MIHMS. The charges billed on the claim lines must match the charges billed on the EOB, or the claim will be denied.

Facility Licenses Under Title 5

Providers whose facility license is under a Title 5 review may use their Title 5 notice to extend their enrollment with fb88Care in MIHMS by six months, and for every six months thereafter, until the Title 5 review is resolved. Providers must complete this update by submitting a maintenance case via the Health PAS Online Portal. Providers can utilize the Provider Maintenance User Guide for a step-by-step guide for submitting a Title 5 Maintenance Case.

Annual 1115 Substance Use Disorder (SUD) Waiver Post Award Forum

On December 22, 2020, fb88 DHHS announced the Center’s for Medicare & Medicaid Services (CMSs) approval of fb88Care’s waiver request, which lifts the federal restriction for residential or inpatient SUD treatment programs beyond 16 beds. The Implementation Plan was approved on July 26, 2021, which allows fb88Care to begin collecting federal funds for residential treatment facilities that expand their capacity.

fb88Care Provider Enrollment Progress Update

Gainwell continues to reduce the time it takes to complete their steps within the fb88Care enrollment process. Gainwell completed 559 enrollment cases in March and the average turnaround time for case completion was approximately 20 days. Case inventory was 578 at the end of March and the average system age of a case in inventory dropped to approximately 16.4 days old.

Additionally, to improve fb88Care enrollment, the Office of fb88Care Services (OMS) and Gainwell: