LUTZ BUSINESS INSIGHTS

 

Enrollment

Medicaid Provider Screening and Enrollment + Revalidation

KIRK DELPERDANG, HEALTHCARE director

 

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

402.496.8800

kdelperdang@lutz.us

LINKEDIN

KIRK DELPERDANG + HEALTHCARE DIRECTOR

Kirk Delperdang is a Healthcare Director at Lutz with over 28 years of experience. He provides healthcare enrollment services to clients with a focus on Medicare providers and reimbursement analyses. In addition, he is responsible for leading Lutz's cost report service line.

AREAS OF FOCUS
AFFILIATIONS AND CREDENTIALS
  • Healthcare Financial Management Association - Nebraska Chapter, Member
  • Nebraska Society of Certified Public Accountants, Member
  • Certified Public Accountant
EDUCATIONAL BACKGROUND
  • BA in Accounting, University of Northern Iowa, Cedar Falls, IA
COMMUNITY SERVICE
  • 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

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