Qualified Laboratories. When an out-of-network qualified laboratory provides medically necessary toxicology test results to the referring health care provider within two business days of receipt of the test specimen, the MCOP shall pay that laboratory at least sixty percent of the Medicaid laboratory services fee schedule. ODM defines “within two business days of receipt of the test specimen” as two business days from the time of collection to when the test results are received by the provider. For urine drug screens, the ODM urine drug screen guidelines shall be followed as specified in Appendix G of this Agreement. For the purposes of this requirement, a qualified laboratory is a laboratory that is enrolled with Medicaid as an independent laboratory, and that meets all of the following conditions: 1. Is accredited by the College of American Pathologists; 2. Is approved by the New York Clinical Laboratory Evaluation Program; and 3. Indicates to the MCOP that is it providing services and billing as a qualified laboratory under this requirement. The MCO is not prevented from conducting program integrity activities for any laboratory submitting claims for services under this requirement. For any such work, the requirements in Appendix I and elsewhere of this Agreement (such as deconfliction and other requirements) apply.
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Samples: Provider Agreement, Provider Agreement
