N.Y. Comp. Codes R. & Regs. tit. 18 § 514.5

Current through Register Vol. 46, No. 51, December 18, 2024

Section 514.5 - Card swipe

(a) The MA recipient identification card is a plastic card which can withstand repeated use. This card, with or without a photograph of the recipient, is the card most commonly used by the MA program throughout the State.

(b) The plastic identification card has a magnetic strip on the reverse side containing encoded information which is read by the MET.

(c) If the department requires a provider to use a MET, the provider is also required to insert the recipient's plastic card into the MET and "swipe" the card through the terminal in order that the MET may read the encoded information.

(d) If the card swipe capability is not functioning or if the recipient does not have a plastic identification card (e.g., the recipient has a temporary MA identification card or replacement card), the provider must manually enter the recipient information into the MET or use the alternative telephone verification procedure provided for in conjunction with EMEVS to verify eligibility.

(e) If a provider who is required to use a MET does not use the card swipe capability of the MET in a significant number of its weekly MA transactions, the department may withhold payment of claims equivalent in dollar value to the percentage of claims in such weekly transaction period with respect to which the provider failed to use the card swipe capability pending an audit or review of the claims submitted and the provider's service and claiming practices. If the department finds a significant number of unjustified failures by the provider to use the card swipe capability, the department may treat such provider failures as an unacceptable practice under Part 515 of this Title.

N.Y. Comp. Codes R. & Regs. Tit. 18 § 514.5