Georgia DCH Reminder For Medicaid Provider Revalidation

Representative Jesse Petrea has forwarded an update that he received earlier today concerning the approaching deadline of September 15th for all Medicaid providers to revalidate their credentials. This revalidation process must be completed to assure that providers continue to receive their Medicaid reimbursements for services rendered to Medicaid members.

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Please note the following key items:

1. Per Federal Regulations, State Medicaid Agencies must revalidate the enrollment of ALL providers regardless of provider type. (See 42 CFR 455.414). Per DCH’s Centralized Credentialing Verification Organization (CVO), we require providers to revalidate every three years. 
2. Over the years, DCH has extended the deadline for providers to complete the revalidation process. Most recently, in 2019, DCH opted to extend the deadline for providers to revalidate. Thereafter, revalidation requirements were paused due to the national Public Health Emergency.  
3. Throughout the PHE, Gainwell Technologies, a vendor acting on behalf of DCH, conducted direct outreach to providers to encourage them to complete the revalidation process.
4. We have made significant effort to keep providers informed about the requirement to revalidate, including direct mailings, banner messages (mass communications that are sent to all enrolled providers), and presentations in various public forums, including Medicaid Fairs, Care Management Committee meetings, the Georgia Hospital Association, Georgia Academy of Pediatricians, and HomeTown Health.  
5. Many providers have still not completed this requirement despite continued outreach, and DCH anticipates that some will miss the deadline. Once the deadline has passed, and they are suspended as providers, they will be unable to receive reimbursement for services. We anticipate these providers will begin to reach out at that time regarding unpaid claims.
6. If a provider allows their credentials to lapse, they will not be reimbursed for claims during the period between September 15 and when they do submit their revalidation. There will not be a retroactive period for unpaid claims.
7. The revalidation process only takes about 20 minutes to complete. Gainwell has developed a step-by-step guide to assist providers with understanding how to complete the requirements. This has been posted on the provider website, mmis.georgia.gov.

If you haven’t already completed your revalidation process, please be sure to do so no later than September 15, 2023.

For further information, please contact:

• Dave Lamb, Legislative Chair, HCAOA Georgia Chapter
• E:  davelamb@caremastermedical.com

Please click here for more information on the Medicaid Provider Revalidation Process.