Source: Ohio Department of Medicaid
Federal regulation 42 CFR 455.414 requires that state Medicaid agencies revalidate the enrollment of all Medicaid physicians and other health care providers – regardless of provider type – at least every five years.
In 2013, the Ohio Department of Medicaid (ODM) launched its revalidation process and schedule and has since issued more than 40,000 revalidation notices.
ODM is now issuing revalidation notices to all remaining providers who have an Ohio Medicaid provider agreement with an effective date preceding March 25, 2011, and have not yet been revalidated.
This round of revalidation notices includes nursing facilities, hospitals, and home and community-based waiver providers (both independent providers and agency providers).
The Process
All remaining providers will first receive a 90-day notice for revalidation prior to their Medicaid agreement end date. This notice includes specific instructions and an application tracking number (ATN). The ATN allows an easy way for providers to review and update current demographic and provider-specific information on file with ODM.
Providers who fail to respond will receive a second reminder notice from ODM 30 days before their Medicaid agreement end date.
Important
If ODM does not receive a response within the 90 days preceding the Medicaid agreement end date, the provider agreement will be terminated and providers will not be eligible for claims reimbursement.
Other information
All revalidation notices are sent to the “mail to” address currently on file in MITS. Please remember that address maintenance is a self-service feature available to all providers through the MITS Secure portal.
ODM will post a list of revalidation dates on medicaid.ohio.gov. This information will be provider-specific by NPI or Medicaid ID under the provider tab.
Please contact Medicaid at 800.686.1516, should you have questions about revalidation. Medicaid staff will be able to answer general questions and assist with specific provider issues.