New enrollment screening criteria under the Affordable Care Act requires regular revalidations for all providers enrolled in the Medicare and Medicaid programs. While the Centers for Medicare and Medicaid Services (CMS) begins round two for Medicare revalidations, Indiana providers face a March 26, 2016, deadline for the first round of revalidations with the Indiana Health Coverage Programs (IHCP).
Providers must revalidate their Medicaid enrollment separately from their Medicare enrollment. The deadline for this round of validations is March 26, 2016, for any provider enrolled with the IHCP before January 1, 2012. CMS has directed states to disenroll any provider that fails to revalidate.
Like Medicare revalidation, Medicaid revalidation is a re-enrollment process, not an update process. Providers should have received notification letters 90 and 60 days in advance of the revalidation deadline. Notices were mailed to the Mail To address indicated on the provider’s service location profile. Providers are not able to revalidate until they receive their notification letter.
To complete their revalidation, providers should complete the entire IHCP provider enrollment packet, not just those fields with new information, marking “Revalidate Enrollment” in item 1. (There is not a separate revalidation application for IHCP.) As well, providers with multiple service locations must revalidate the enrollment of each service location. Incomplete packets will be returned to providers with a request that they be resubmitted with the missing information added.
During the revalidation process, different providers are required to submit different supplementary documentation based on their provider type. IHCP has a complete list of required documentation by provider type in a matrix on their website. As well, certain providers must pay a revalidation enrollment application fee, while other providers are exempt. A complete list of application fees by provider type is also available on the IHCP website.
Providers that do not intend to revalidate their enrollments should submit the IHCP Provider Disenrollment Form to notify the IHCP of a voluntary disenrollment. Providers should not wait for the IHCP to perform an involuntary disenrollment at the end of the required revalidation period.
Three Important Things to Note
- Providers also should submit a properly completed Internal Revenue Service (IRS) form W-9 with their IHCP provider enrollment packet. Discrepancies between the IRS form W-9 and the information provided on the IHCP enrollment forms will result in the packet being returned to the provider, delaying revalidation.
- Disclosures on Schedule C of the enrollment packet must contain complete and thorough information about all disclosed individuals, including name, Social Security number, and date of birth. The Schedule C must contain a complete list of disclosures, not just those individuals added or deleted from a prior disclosure.
- Group providers should disregard the IHCP Rendering Provider Enrollment and Maintenance Packet portion of the IHCP group provider enrollment packet when revalidating. However, a group should include a list of rendering providers linked to the service location at the time of revalidation as an attachment to the group’s enrollment packet. The list of rendering providers must include the information outlined in the instructions of the IHCP group provider enrollment packet.
For more information about Indiana Medicaid Revalidation, visit the Indiana Medicaid Revalidation website or review the recent IHCP banner page which clarifies Provider Enrollment revalidation requirements.
— All rights reserved. For use or reprint in your blog, website, or publication, please contact us email@example.com.