Medical Assistance 1099 Information
 
What is a 1099-MISC?

Form 1099-MISC, U.S. Information Return, is a federally required form. The IRS has a number of 1099 variations in use. Medical Assistance (MA) deals with 1099-MISC forms only for MA purposes; this form is used to indicate the amount of payments made to a particular Social Security Number (SSN) or Tax Identification Number during a calendar year for tax purposes. The Office of Medical Assistance Programs is required by law to issue1099 forms to the same SSN or Tax Identification Number for which MA payments were made throughout the previous calendar year.
 
 
Frequent Concerns from MA Providers About 1099-MISC Forms from the Office of Medical Assistance Programs
 
The dollar amount on my 1099-MISC form does not match the dollar amount on my remittance advice.
A provider or group that has more than one address code must total the last remittance advice page of the calendar year for each location code. Reference the ‘NEW YTD BALANCE’ located as the final field on the Remittance Advice (RA) summary when accounting for all service locations on the final RA of the year:
 
Example:

Location Code 0001 =

$700.00 (from last remittance advice of year)

Location Code 0002 =

$500.00 (from last remittance advice of year)

Location Code 0003 =

$400.00 (from last remittance advice of year)

 

$1,600.00 (total shown on 1099 form)

I received a 1099 form from Medical Assistance but never received any payments.

  • If you are a rendering provider who is enrolled in a group, and claims submitted for you to MA did not indicate the group as the payee by utilizing the groups’ MPI number in the appropriate field and checks were issued in your name and Tax Identification Number. The 1099-MISC form reflects the correct Tax Identification Number based on claims billed, and we cannot issue a revised 1099-MISC form. Please contact the IRS for information on reporting these payments. For future billings to MA, be sure to indicate both the rendering provider and group (payee) provider identification numbers. Payment will then be made to the group, and will be reflected on the group’s 1099-MISC form under the appropriate tax ID number.
  • If you became enrolled with a group during the calendar year, but received payments directly before enrolling with the group, you will receive a 1099-MISC form indicating the total of payments that were made directly to you and reported under your social security number. Also, if payments were made directly to you even after you enrolled in the group because the claims submitted did not include the group number, then the 1099-MISC form reflects the correct taxpayer identification number, and we cannot issue a revised 1099-MISC form.

I received a 1099-MISC form from Medical Assistance. Can you provide a list of patients, dates of service etc. that this 1099-MISC form relates to?

When you received payments from MA, you also received RAs showing detailed information about what the payments were for. RAs are to be retained in providers’ offices for at least four years. Providers can access RAs by accessing the PROMISe website. You must register on-line in order to access secure information. How can I prevent 1099 problems?

How can I prevent 1099-MISC form problems?
  • Please review all MA RAs and checks immediately upon receiving them from the department. If the name of the individual provider appears on the check, then the payment was recorded under the individual provider’s Tax Identification Number and not under the group’s Tax Identification Number, and payment will be reflected on the individual provider’s 1099-Misc form.
  • Keep the IRS Maintenance address up to date (should be identical to the information the IRS has on file for the same tax ID.)
  • Dis-enrolling as a member of a group when participation with the group has ended.
  • Validate that the PAY TO address on file is up to date and does not match that of the group’s.
If payment was made under an incorrect provider number, adjust all appropriate claims by submitting via our website, other electronic submission or by submitting an original claim form to the appropriate mailing address based on your type of claim type. After the claims have been adjusted you may refund the department by sending a check to:
 
Office of Medical Assistance Programs
Bureau of Fee-for-Service Programs
P.O. Box 8050
Harrisburg, PA 17105
 
The check will be re-deposited in the State Treasury; a gross adjustment to cancel the credit balance and reduce the year-to-date total will be processed. When the claims appear as voided on the RA, new claims can then be submitted showing the correct Medical Assistance Identification Number(s). This process must be completed before the close of the tax year to be reflected on that calendar year’s 1099-MISC form.
 
NOTE: Individual should contact the group to request that the group prepare and issue a letter to the IRS attesting that the monies reflected on the 1099-MISC form issued by the department was received and deposited by the group since the individual was an employee of the group at the time in question. Both the IRS and the individual should receive a copy of the group’s attestation to file with tax records. If the situation is such that the group is unwilling to provide written attestation to the IRS, the individual should contact the department 1099 unit help resolve the matter with the IRS.
 
NOTE: A statement to the department indicating that checks were made payable to and endorsed by the individual provider and deposited into a group/corporate account is not acceptable documentation to request a corrected 1099-MISC form. Acceptable scenarios for corrected 1099-MISC form requests are:
  • Recipient’s Tax Identification Number on 1099-MISC form is incorrect in relation to the recipient name on the 1099-MISC form
  • The Compensation amount listed in Box 7 of the 1099-MISC form is inconsistent with the information provided on those claims received; fully processed; and acted upon by MA during the tax year in question.
NOTE: The 1099 Unit does not adjust provider claims.
 
All written requests should include the requestor’s direct contact information.
 
Additional questions regarding Medical Assistance 1099-MISC forms must be in writing and sent to:
 
Department of Human Services
Office of Medical Assistance Programs
Division of Operations
Attention: 1099 Unit
P.O. Box 8050
Harrisburg, PA 17105