Provider revalidation requirement

Date: 09/20/19

Heritage Health (Medicaid):

Reminder: Per 471 NAC 2-001.02D and 42 CFR 455.414, the Department must revalidate the enrollment of all providers every 5 years. Beginning 1/31/19, providers who are in a revalidation period (within 6 months prior to the revalidation due date) will be subject to the rules regarding the revalidation of their Medicaid provider enrollment located in Provider Bulletin No. 19-06.

Providers will begin receiving email correspondence (directed to their designated provider agreement point of contact listed in Maximus) related to revalidation beginning 180 days prior to their revalidation due date.  Subsequent 30 day reminder notices will be delivered thereafter up until day 30 before the revalidation due date.  It is important for providers to keep all data within their enrollment current. 

Failure to complete revalidation in entirety by the revalidation due date will result in claim payment disruption and will prevent provider client prescriptions from being processed at point of sale.  We strongly encourage providers to complete the revalidation process through Maximus as soon as possible. 

Questions concerning this bulletin and provider revalidation should be directed to Maximus by email or at 1-844-374-5022.