June 2013 ACA Section 1202 Web Attestation Forms should now be submitted electronically. Please see the attached alert for more details. PCP Attestation Alert To submit an attestation form please sign into the Interactive Services Tab
**** Attention Diamond State Partners Behavior Health Providers ****
Starting July 1, 2012 all Diamond State Partners Behavioral Health authorizations will be sent to Attention DMMA at fax number 302-255-4481.
The behavioral health authorization forms continue to be located in the General Policy Manual located on the DMAP website.
General Policy Manual
**** Attention ****
The Medicare Prescription Drug Coverage information can now be found on the Downloads tab under the Forms link.
The 5010 D.0 Information can now be found on the Information tab
Based on Code of Federal Regulations (CFR) 455.100, DMAP providers
will be required by CMS to submit a disclosure form each year. This updated
disclosure form will be required of all enrolled providers. A disclosure
form feature and instructions will be added to the DMAP Website. All disclosures
must be submitted via the DMAP Website (i.e., no paper copies or faxes).
State of Delaware Announcement for Medicaid
Effective April 1, 2012, providers are to start
billing the MCOs for covered services for clients enrolled in Diamond State Health Plan Plus.
Providers, it is currently your responsibility to check client eligibility and managed
care enrollment before providing services to a Medicaid recipient. This will be even more
important now with more recipients and more services being covered by managed care organizations.
New managed care clients will have an additional insurance card from their MCO: either from
DPCI or UnitedHealthcare.
Managed Care Organization Contact information as of April 2012 for DSHP Plus:
LTC Provider Services 800-600-9007
LTC Member Services 877-542-9248
Delaware Health and Social Services (DHSS) is the agency that is responsible
for the overall administration of the Medicaid Program (Title XIX) and
various other medical assistance programs for the State. The administration
process is handled at the operational level through the Delaware Medical
Assistance Program (DMAP) as part of the Division of Medicaid and Medical Assistance (DMMA).
The purpose of the DMAP is to furnish medical assistance to eligible families
of low-income and to eligible people who are aged, blind and/or disabled whose income
and resources are insufficient to meet the cost of necessary medical services.
Medical coverage provided under Medicaid includes hospital, outpatient
clinic, lab and physician services, prescriptions, nursing home care and
many other medical services. Services are available through providers statewide
who contract with DSS.
Diamond State Partners is a new managed care program, administered by the
Delaware Medical Assistance Program (DMAP) in partnership with participating
Any active DMAP Provider who currently bills EDS for Medicaid clients can
also bill EDS for services to a client enrolled in Diamond State Partners.
The same 10-digit DMAP Provider Number issued to a Medicaid provider can
be used for Diamond State Partners. If you are a Medicaid provider then
you are a Diamond State Partners provider. If you would like more information
about enrolling as a Diamond State Partners provider, call DSP Member Services
at 800-390-6093 or
For forms and more policy information regarding DSP, click here DSP information.
The pharmacy program in Delaware is operationally administered through
the Delaware Medical Assistance Program (DMAP) in concert with EDS staff
that includes a Pharmacy Consultant and Pharmacy Team. The objective of
the pharmacy program is to ensure that Medicaid clients have access to
appropriate medications while monitoring utilization and cost-effectiveness.
The rapid changes in the pharmacy industry and the importance of communicating
new information to the pharmacy community are critical to the quality and
continuity of care for Delaware citizens. The Pharmacy Corner can be accessed
through this link for pharmacy-related issues and data.
This site was designed for use by the medical provider community. If you
are looking for personal state health programs please refer to the
Delaware State Web Page .
Electronic verification systems are available 24 hours a day, 7 days a week except during routine maintenance outages that will be periodically scheduled on Sundays between 7PM and 12AM Eastern Time.