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MassHealth Revalidation of Nurse Practitioners

Thursday, August 28, 2014   (0 Comments)
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The MCNP has been contacted by MassHealth Provider Relations with a request that we update our membership about the MassHealth Provider Revalidation Initiative which is currently underway.

This initiative is in response to Section 6401 of the Affordable Care Act which established a requirement for Medicare and Medicaid to revalidate enrollment information for all enrolled providers, regardless of provider type, under new enrollment screening criteria at least every five years.

As part of this required revalidation process, MassHealth must revalidate the enrollment information and, if needed, collect an updated Federally Required Disclosures Form from all enrolled providers. Other information may also be required.

MassHealth began its revalidation initiative in March 2014 and
is currently focusing on providers in certain provider groups who enrolled on or before March 25, 2011. Nurse practitioners are one of the provider groups currently being revalidated.

Because of the large volume of providers currently being called to revalidate, MassHealth is, in some cases, only calling on a portion of certain provider types to revalidate at this time. With that said, we have been informed by MassHealth that revalidation letters have already been mailed to a subset of NPs on July 15th, and another group will be receiving letters this week.

It is critical that you respond to these letters as revalidation is not optional , and failure to comply will result in disenrollment as a MassHeatlh provider.

There are extensive resources to explain the process on the website including a very helpful FAQ sheet which be found at the links below:
Rick Flaherty
Provider Relations Specialist
MassHealth Customer Service Center
tel: 857-472-5653

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