The Missouri Medicaid Audit and Compliance Unit (MMAC) wishes to remind providers about incentives that are “kick-backs” and therefore not allowed.   The federal Anti-Kickback Statute is a criminal law that prohibits health care providers in a federal health care … Continued

Missouri state regulation defines “adequate documentation” as documentation from which services rendered and the amount of reimbursement received by a provider can be readily discerned and verified with reasonable certainty.  It is a program violation to fail to make available … Continued

State and federal regulations (13 CSR 65-2 and 42 CFR 455.432) require pre-enrollment and post-enrollment site visits of providers who are designated as “moderate” or “high” categorical risks to the Medicaid program.  The purpose of the site visits is to … Continued

State and federal regulations (13 CSR 65-2 and 42 CFR 455.460) require Missouri Medicaid Audit and Compliance (MMAC) to collect an application fee from all new and revalidating “institutional” Medicaid providers.  “Individual” providers such as physicians, dentists and other individual non-physician … Continued