The Medicaid program now allows Ordering, Referring, and Prescribing (ORP) provider enrollment for those who contract privately with patients.  This is instead of enrolling as a rendering provider (and accepting Medicaid contract terms).  The ORP option accommodates psychiatrists who have private pay arrangements with patients while Medicaid pays for the prescriptions they order.  This new option is somewhat like opting out of Medicare but has fewer requirements.

Before October 1, 2019, you must enroll as an ORP (or as one of the rendering provider options) for prescriptions to continue to be paid by Medicaid.  If you have not enrolled, payment for prescriptions will be rejected at the pharmacy.  Please see more details here.