Provider Revalidation process beginning in December of 2013

The Medicaid Program of the Health Care Authority (agency) is implementing a provider revalidation process beginning in December of 2013.  Providers will be notified by letter when they are selected for revalidation.  No action is required until providers receive the revalidation letter from the agency. Federal regulations contained within the Affordable Care Act require the agency to be in compliance with enhanced provider screening rules designed to prevent fraud, waste, and abuse within the Medicaid Program. As a result, the agency must revalidate the enrollment of all Medicaid providers at least once every five years. The provider revalidation process includes federal database checks, reviews by the agency to ensure providers are in compliance with current federal and state regulations, and may include site visits performed by the agency. The agency will ask providers who are selected for revalidation to update ownership and managing-employee information on file with the agency, and to submit documents that may include a new provider agreement, a W-9 form, a Medicaid Disclosure Statement, and other documents as needed.