Wednesday, August 19, 2015
The purpose of this Transmittal is to update the appeals procedure that governs the out-of-pocket (OOP) reimbursement process consistent with the requirements of the Salazar Court’s May 18, 2015 Order. Medicaid beneficiaries may be reimbursed for OOP expenses used for covered prescriptions, doctor visits, hospital stays and other services that are available under Medicaid and should have been paid by the program.