New Rules Require Medicaid Provider Revalidation

On March 25, 2011 significant new Federal regulations were implemented that have a direct impact on Medicaid enrolled providers. New information from the New York State Medicaid Program’s Medicaid Update confirms that the rules will be implemented shortly for New York providers.

The new rules require that all enrolled providers revalidate their enrollment at least every five years. According to NYS Medicaid Update “[r]evalidation will include attestation of credentials as well as the agreement to abide by the rules and regulations of the Medicaid program. Certain provider types will be required to pay a fee for revalidation.”

New York plans to begin revalidation of its ordering and referring providers in the fall of 2012. It is anticipated that revalidation will be rolled out by provider type. According to Medicaid Update,

[c]orrespondence will be sent to providers, advising them of their need to revalidate their enrollment. Providers will then have 150 days from receipt of the notice to complete the process. Failure to comply with the revalidation and attestation within the timeframe will result in provider disenrollment.