LUTZ BUSINESS INSIGHTS
Medicaid Provider Screening and Enrollment + Revalidation
KIRK DELPERDANG, LUTZ HEALTHCARE MANAGER
The Nebraska DHHS (Department of Health and Human Services) issued Provider Bulletin No. 15-53 dated November 17, 2015. The purpose of this bulletin was to offer additional information regarding the new provider screening and enrollment requirements and processes implemented by DHHS and carried out by Maximus. 42 CFR 455, Subpart E mandates the revalidation of all providers at least every five (5) years, regardless of provider type.
As you know, the Maximus provider enrollment web portal was implemented on December 1, 2015. A significant requirement within the initial phases of this implementation is the revalidation of all providers enrolled in Nebraska Medicaid. Any provider enrolled with Nebraska Medicaid as of March 2011 will need to be revalidated prior to November 25, 2016.
Although revalidation may be completed at any time, Maximus will soon be sending letters to the impacted enrolled providers across the state in three phases. Upon notification, providers will have 60 days to complete the revalidation. A second notice will be sent 30 days prior to the revalidation due date to providers that have not completed their revalidation.
Providers that do not complete revalidation by their due date will have their enrollment ended the same day. For those providers who enrolled with Nebraska Medicaid after March 2011, revalidation will have to be completed by the end of the five 5 year period from their enrollment effective date.
ABOUT THE AUTHOR
KIRK DELPERDANG + HEALTHCARE MANAGER
Kirk Delperdang is a Healthcare Manager at Lutz with over 25 years of experience. He provides accounting and consulting services to healthcare and related organizations.
AREAS OF FOCUS
- Healthcare Industry
- Medicare Enrollment
- Financial Analysis
AFFILIATIONS AND CREDENTIALS
- Healthcare Financial Management Association - Nebraska Chapter, Member
- Nebraska Society of Certified Public Accountants, Member
- BA in Accounting, University of Northern Iowa, Cedar Falls, IA
- St. Vincent de Paul, Knights of Columbus, Member
- Active in various youth sports leagues: Aldrich Elementary, Millard Athletic Association, Millard North Schools, Omaha FC, Skutt Catholic High School and YMCA
- 2019 OOPS + ASC Proposed Federal Registers
- Provider Enrollment Updates
- CMS Survey & Certification Emergency Preparedness Initiative
- Medicare Provider Enrollment
- Risk Tolerance + Payor Contract Reviews/Audits
- OIG Work Plan Update
- 2018 Proposed Federal Registers + OPPS & ASC
- Classification of Provider-Based Space a Key Consideration for Rural Hospitals
- Summary: CMS 2018 IPPS Proposed Rule
- Medicare Provider Enrollment
- OIG Work Plan 2017
- RHC Billing
- Medicaid Provider Screening and Enrollment + Revalidation
- Provider Enrollment
- Provider-Based Arrangements
- The CFO Outsourcing Option for Hospitals and Why it May Make Sense for You
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