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Transmittal 19-21-Revised Prescription Order Form (POF) for Long Term Services and Supports (LTSS)


Tuesday, September 17, 2019

Transmittal 19-21: The Department of Health Care Finance (DHCF) is revising its format for the Prescription Order Form (POF) to establish standards governing the assessment process for the level of need for beneficiaries who receive Long Term Services and Supports (LTSS). An updated version of the POF (version 9/1/19) was created to ease completion of the form, where previously both the Medicaid Provider ID number and National Provider Identifier (NPI) number were required fields. With this most recent revision, the required field of Medicaid Provider ID has been eliminated to reduce unnecessary redundancies. However, the National Provider Identifier (NPI) Number is retained in the revised POF as a required field (See Section 3 of the POF-Physician/APRN Information). DHCF has replaced version 9/12/18 on our website with the 9/1/19 form, effective October 1, 2019.