Missouri Medicaid Audit & Compliance » From The Director Archives Archives

FROM THE DIRECTOR

December 30th, 2024

The Missouri Medicaid Audit and Compliance Unit (MMAC) expects all enrolled MO HealthNet providers to keep their information up to date as required in the Code of State Regulations. Any changes can be reported to MMAC by using the Provider Update Request. Please fax the form and any accompanying documents to 573-634-3105. Questions? Please contact MMAC Provider Enrollment at MMAC.ProviderEnrollment@dss.mo.gov.

- 13 CSR 65-2.020(11) The provider shall advise MMAC, in writing, on enrollment forms specified by MMAC, of any changes affecting the provider’s enrollment records within ninety (90) days of the change, with the exception of change of ownership or control of any provider which must be reported within thirty (30) days.
- (A) The Provider Enrollment Unit within MMAC is responsible for determining whether a current MO HealthNet provider record shall be updated, or a new MO HealthNet provider record is created. A new MO HealthNet provider record is not created for any changes, including but not limited to change of ownership, change of operator, tax identification change, merger, bankruptcy, name change, address change, payment address change, Medicare number change, National Provider Identifier (NPI) change, or facilities/offices that have been closed and reopened at the same or different locations. This includes replacement facilities, whether they are at the same location or a different location, and whether the Medicare number is retained or if a new Medicare number is issued. A provider may be subject to administrative action if information is withheld at the time of application that results in a new provider number being created in error. The division shall issue payments to the entity identified in the current MO HealthNet provider enrollment application. Regardless of changes in control or ownership, MMAC shall recover from the entity identified in the current MO HealthNet provider enrollment application liabilities, sanctions, and penalties pertaining to the MO HealthNet program, regardless of when the services were rendered.

To ensure that the provider’s information update is completed in timely manner, the provider must consider the following when submitting the provider update request form to MMAC;

- Signature: accepted signature by MMAC is either an ink signature or one of the approved electronic signatures.

- Individual Provider’s signature is required in the following updates: o Main practice location update. o Provider is updating enrollment from 03 – billing to 13 – performing. o Change in the pay to information.

- For entity’s Provider Update request, the signer must be authorized personnel that is listed with MMAC on the provider’s ownership as a managing employee or an owner.

- Most Missouri Medicaid providers can update the additional practice location for their enrollment on EMOMED. Except the following: o Provisionally licensed counselors o Advanced Nurse Practitioners o Federally Qualified Health Center o Dialysis Clinic o Ambulatory Surgery Center o Rural Health Clinic

If the provider is having technical issues with adding or removing the additional practice locations, then they will need to contact EMOMED Helpdesk at: (573) 635-3559.

Tags: Provider Updates
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MMAC’s Provider Communication Portal Has Closed

December 24th, 2024

MMAC has closed the Provider Communication Portal. MMAC and other key stakeholders have been hard at work to finalize a contract for a new, comprehensive Provider Enrollment System. The new system will be used for new provider enrollments and revalidations. The new Provider Enrollment System will also have an integrated (rather than stand-alone) Self-Service Portal.

As MMAC embraces new technology we want to lessen the inconvenience for our providers. Therefore, MMAC has discontinued the use of the Provider Communication Portal, which was launched in August 2024.

MMAC is returning to our previous methods of communication with providers via email and phone. Providers still have various ways to contact MMAC’s Provider Enrollment Unit by emailing mmac.providerenrollment@dss.mo.gov, the Contracts Unit at mmac.ihscontracts@dss.mo.gov, or the Revalidations Unit at mmac.revalidation@dss.mo.gov.

More information will be forthcoming regarding the launch of the new Provider Enrollment System. Projected date for the new Provider Enrollment System is mid-2026.

Thank you for your patience and support as we seek the best technological advancements to best serve you and streamline the work for MMAC. Don’t hesitate to contact us with any questions at (573) 751-3399.

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Public Notice

November 8th, 2024

Based on the actions of the Centers for Medicare and Medicaid Services, notice is hereby given that the agreement between the Missouri Department of Social Services and Festus Manor as a provider of services in the MO HealthNet (Medicaid) program, will be terminated at the close of business November 23, 2024.

To facilitate the orderly relocation of MO HealthNet beneficiaries, for residents admitted August 6, 2024, or earlier, payment may continue for up to 30 days for services furnished after November 23, 2024.

Todd Richardson, Director

MO HealthNet Division

Department of Social Services

Tracy Niekamp, Administrator

Section for Long-Term Care Regulation

Department of Health and Senior Services

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ELECTRONIC SIGNATURE REQUIREMENTS

November 8th, 2024

All forms submitted to MMAC must have an original handwritten signature or a verifiable electronic signature using an electronic signature software such as; DocuSign,Adobe Sign, DropBox Sign.Some of these software offer free limited accounts.

If in the course of reviewing your documents an unverifiable or altered form utilizing electronic signature is found or suspected, providers will be required to either submit the original documents showing the authentication trail meeting the requirements below or produce new forms with valid handwritten signatures.

All Medicaid providers using electronic signatures must meet the following requirements:

• Implement a reliable method of verifying the identity of the signing party. To ensure the validity of the electronic signature, the provider must produce the digital certificate or any other tracking trail document showing the authenticity of the signature. The certificate should include but not limited to: Signing E-mail address, time stamp, IP addresses.

• Retain the certified and unaltered original documents and the Certificate of Completion for a minimum of five (5) years. The electronic document and signature should be kept secure to preserve its integrity by preventing unauthorized changes and maintaining the completeness of the agreement. DocuSign, Adobe Sign, and Dropbox Sign files are subject to the document retention requirements outlined in the provider’s Title XIX Participation Agreement, 13 CSR 70-3.030(3)(A)(4), and the appropriate MO HealthNet Provider Manual.

For questions, contact MMAC.

Tags: electronic signature, signature requirements
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MO HealthNet Providers: Call Us For FREE!

October 8th, 2024

The Mo HealthNet Provider Communications Unit assists providers with eligibility and coverage verification, enrollment status, annual review dates, questions regarding proper claim filing, claims resolution and disposition, billing errors, verifying check amounts, and more.

Providers are encouraged to communicate with Provider Communications using the Provider Communications Management tool in eMOMED. Providers may also call the Interactive Voice Response (IVR) system at (573) 751-2896.
Beginning today, providers can also call Provider Communications TOLL FREE at (833) 222-7916. The caller must have the provider’s National Provider Identifier (NPI). The IVR system allows a MO HealthNet provider six options:

Press 1 for MO HealthNet Participant Eligibility
Press 2 for Check Amount Information
Press 3 for Claim Information
Press 4 for Provider Enrollment Status
Press 5 for MO HealthNet Participant Annual Review Dates
Press 6 to Speak to a Representative for Other Issues

For more information on the IVR system, review Section 3.3 of the General Sections Manual. For questions, contact MHD.Education@dss.mo.gov.

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4TH ROUND TESTING FOR THOSE WHO MISSED OR DIDN’T PASS THE FIRST AND SECOND ROUNDS, NEW CDS PROVIDERS – CONSUMER DIRECTED SERVICES (CDS) MANAGER REQUIREMENT – PER 19 CSR 15-8.400(1)D

August 12th, 2024

4TH ROUND TESTING FOR THOSE WHO MISSED OR DIDN’T PASS THE FIRST AND SECOND ROUNDS, NEW CDS PROVIDERS APRIL/MAY – CONSUMER DIRECTED SERVICES (CDS) MANAGER REQUIREMENT – PER 19 CSR 15-8.400(1)D

PLEASE READ TO THE END

Per the updated CDS regulation (19 CSR 15-8.400(1)(D), all CDS providers are required to have a Certified CDS Manager. Please see the original FROM THE DIRECTOR notification https://mmac.mo.gov/cds-manager-testing/ posted to the MMAC website on March 8, 2024.

No GRANDFATHERING – ALL CDS providers MUST HAVE a Certified CDS MANAGER who has passed this test. If you or one of your employees has attended the CDS Orientation or passed and/or is currently an In-Home Services Designated Manager – neither of these will apply nor be used for passing the Certified CDS Manager test. ANY PAST TRAININGS WILL NOT APPLY TO MEET THIS REQUIREMENT.

For those who did not attend or pass the first three rounds of testing, newly enrolled or pending:

The ONE person who will be the CDS Manager will be allowed to sign up to take the test
Register for ONLY ONE of the test dates below that best fits their schedule
Registration links will be emailed to the providers – DO NOT share the link with anyone else

DO NOT register for all three dates or register more than one person, please mark your calendars.

Test Dates

Thursday, August 22, 2024

Wednesday, August 28, 2024

Tuesday, September 3, 2024

Thursday, September 12, 2024

Emails with the link to register will go out to those CDS providers not compliant, newly enrolled or pending, Thursday August 15, 2024. The email will be sent to the business email on file with MMAC/MO HealthNet.

First three rounds had some issues with registration and emails, please refer to the WebEx Instruction link for tips and tricks regarding registration and confirmation emails. Registration Instructions: https://mmac.mo.gov/wp-content/uploads/sites/11/2024/01/CDS-Webinar-Instructions.pdf

The virtual testing sessions will start at 9:00 am, please allow 4 hours (1 hour presentation – reason for testing, current trends, quick break, overview of how the test will look, open book material and 3 hours for the test).

Open Book Materials for test: https://mmac.mo.gov/providers/provider-enrollment/home-and-community-based-services/open-book-dm-testing-materials/

Questions regarding the CDS Manager Test can be sent to MMAC.IHSCONTRACTS@DSS.MO.GOV

Tags: CERTIFIED CDS MANAGER TESTING
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PUBLIC NOTICE

July 8th, 2024

Based on the actions of the Centers for Medicare and Medicaid Services, notice is hereby given that the agreement between the Missouri Department of Social Services and Senath South Health Care Center as a provider of services in the MO HealthNet (Medicaid) program, will be terminated at the close of business July 25, 2024.

To facilitate the orderly relocation of MO HealthNet beneficiaries, for residents admitted April 24, 2024, or earlier, payment may continue for up to 30 days for services furnished after July 25, 2024.