Suppression of Member Explanation of Benefits (EOBs) for Medicaid Minors

Date Issued: 8/15/2016

Beginning September 1, 2016, EmblemHealth will suppress EOBs for Medicaid minors (0 to under 18 years of age) for all services* to ensure compliance with New York State Department of Health (NYSDOH) requirements.

EmblemHealth is required by the NYSDOH to enact new policies regarding the confidentiality of Medicaid minors. NYSDOH believes it is necessary to protect the confidentiality rights of minors pertaining to health care services such as: family planning, HIV testing, sexually transmitted disease treatment, mental health services and substance use disorder treatment. A key aspect to NYSDOH’s policy is the suppression of EOBs and related Notice of Actions (NOAs) for these members. This change does not affect provider remits.

*Excludes dental and other services that members are responsible for paying.