Provider Revalidation Deadline Approaching

Medicaid and Medicare providers must periodically revalidate their enrollment with each program. While both programs require revalidation every five years for most providers, these are two separate processes based on separate schedules.  

Medicaid providers whose revalidation is due this year would have been notified by letter earlier this year and would have received a follow-up letter more recently. If your Medicaid revalidation is due this year and you have not yet revalidated, you should act immediately; the revalidation packet must be mailed so as to be received by DOH before Sept. 25, 2016. Providers wishing to confirm that their materials were received may call Computer Sciences Corporation at 800-343-9000. Step-by-step information along with the required forms and Frequently Asked Questions are available here, and a copy of the notification letter is here. Failure to revalidate results in termination from the Medicaid program.

Medicare providers must follow a similar procedure, but are notified by their Medicare Administrative Contractor (MAC) of their Medicare revalidation date. They can also check whether their revalidation date is approaching here. Revalidation dates are typically at the end of the month and are posted approximately six months before they are due. For providers whose revalidation date is further than six months away, "TBD" will appear instead of a date. MLN Matters publication SE1605 outlines the Medicare enrollment revalidation process in detail. FAQs are posted here, and a revalidation checklist is available here.

Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841