Mississippi Medicaid enrolled providers will be required to revalidate their credentials with the Mississippi Division of Medicaid (DOM), beginning this spring. Medicaid provider revalidation is a requirement stemming from 42 C.F.R. § 455.414 of the Affordable Care Act (ACA), which requires all state Medicaid agencies to revalidate the enrollment of all providers at least every five years.
A revalidation requires a provider to verify or revalidate the information currently on his or her provider file. Providers also will need to complete and sign a new Provider Disclosure form and a new Provider Agreement. As part of the revalidation, the state must conduct a full screening appropriate to the provider’s risk level in compliance with 42 C.F.R. Part 455, Subparts B & E, and the provider must comply with any request made by the state as part of the revalidation process within the specified time frame.
Beginning in April 2017, notification letters will be mailed to providers who have been enrolled with Medicaid for five years or more. Revalidation notifications will be issued on a staggered scheduled until notices have been issued to all providers due for revalidation. The revalidation notification will initiate the process with each provider. The letter will provide instructions for completing the revalidation and will indicate the due date.
Providers will be able to revalidate through the Envision web portal in a simple, step-by-step process. If providers fail to complete the revalidation process by the due date in their notice, their Medicaid enrollment will terminate and they will have to reapply.
Additionally, if a provider fails to revalidate in time with Medicaid and they are also enrolled with the MississippiCAN coordinated care organizations (CCO), Magnolia Health and United Healthcare Community Plan, enrollment with the CCOs will be terminated.
This new process will eventually affect all providers, but DOM will begin by targeting those providers who have been enrolled five years or more. Meanwhile, revalidation dates will be set for newer providers who have not yet been enrolled five years.
To prepare for revalidation, all Medicaid providers should take the following steps immediately:
- Providers should verify the address information on file with DOM is correct. The notifications will be mailed to the “Mail Other” address on their file, and if there is no “Mail Other” address, it will be mailed to the Billing address. To ensure each individual provider receives a notification, please validate your addresses on file with DOM.
- If changes are needed, complete the Provider Change of Address form, located on the Forms webpage, under Provider Forms.
- The form must be completed, signed by the provider, and then faxed to CONDUENT Provider Enrollment at 1-888-495-8169.
- Each enrolled provider must register for access to the Mississippi Envision Web Portal in order to revalidate electronically. This will streamline the process and allow providers to enter their own information. Providers can register now by going to www.ms-medicaid.com and clicking the “web registration” link under the User Login section. There they will find instructions for becoming a web portal user.
For more information, contact Provider Enrollment toll-free at 1-800-884-3222.
