All Consumer Directed Service (CDS) providers are required to submit the following reports to MMAC:
CDS Quarterly Financial & Service Report CDS Annual Service Report CDS Annual AuditFor your convenience, these reports may now be submitted to the following email address or fax at:
Email: MMAC.CDS@DSS.MO.GOV
Fax: 573-526-4375
Mailing address: PO Box 6500, Jefferson City, MO 65102-6500
The CDS Quarterly Financial & Service Report and CDS Annual Service Report have been updated and are posted on MMAC’s website. Click here to access fillable copies of these reports.
CDS Quarterly Financial and Service Report
The CDS Quarterly Financial & Service Report must be submitted to MMAC by the “Report Due Date,” as follows:
Calendar QuarterCovered DatesReport Due DateFirst QuarterJanuary 1 through March 31, 2027April 30, 2027Second QuarterApril 1 through June 30, 2027July 31, 2027Third QuarterJuly 1 through September 30, 2027October 31, 2027Fourth QuarterOctober 1 through December 31, 2027January 31, 2028For example, the CDS Quarterly Financial & Service Report for the First Quarter (which starts on January 1 and ends on March 31, 2027) must be submitted to MMAC by April 30, 2027.
CDS Annual Service Report
The CDS Annual Service Report for January 1 through December 31 is due by January 31, 2028.
Before submitting reports, please review for completeness and that the form has been signed (print the name and title of the person signing under the signature).
CDS Annual Audit
Missouri statute and regulation require CDS providers to submit an annual audit.19 CSR 15-8.400(8) states vendors shall submit the annual audit, done by a properly licensed independent practitioner (certified public accountant licensed in the state of Missouri) pursuant to applicable federal and state laws and regulations, within one hundred fifty (150) days after the end of the vendor’s fiscal year.
Missouri Medicaid Audit and Compliance (MMAC) has posted guidance on its website to assist CDS vendors with the financial audit process. Click here to view the guidance.
Before submitting reports, please review for completeness and that the form has been signed (print the name and title of the person signing under the signature).
If you have any questions about your CDS Annual Audit, please contact MMAC at MMAC.CDS@dss.mo.gov with any questions.
Notice for Noncompliant CDS Vendors
If you are unable to submit any of the required reports by the due date, for any reason, you must inform MMAC immediately, with an explanation for why you cannot submit the report by the due date, when you will provide the overdue report, and a detailed corrective action plan addressing how you will comply with the CDS vendor reporting requirements.
It is important that you do not forget to submit your CDS reports and annual audit by the due dates in this bulletin. 19 CSR 15-8.400(9) authorizes MMAC to withhold funding if the vendor does not submit required documentation. MMAC reserves the right to impose administrative actions on CDS vendors who fail to submit any required reports to MMAC under 13 CSR 70-3.030.
Effective August 1, 2026, the Missouri Department of Social Services (DSS), through the MO HealthNet Division (MHD) and the Missouri Medicaid Audit & Compliance Unit (MMAC), in consultation with the Centers for Medicare & Medicaid Services (CMS), is implementing a six-month temporary moratorium on new provider enrollments for the following provider types identified by CMS as posing an increased risk for fraud, waste, and abuse of the MO HealthNet Program:
Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS / DME) Consumer Directed Services (CDS) / Personal CareThis temporary pause on new enrollments applies across the entire state of Missouri. It is designed to strengthen program oversight, reduce opportunities for bad actors to commit fraud, waste, and abuse, and allow MMAC to stabilize and modernize its provider monitoring systems without creating barriers to care for MO HealthNet participants.
Actively enrolled DME and CDS providers are not affected by this temporary moratorium and may continue servicing Medicaid participants. Providers whose enrollment application was received by MMAC prior to the implementation date will also not be affected. The temporary moratoria also do not apply to providers who are revalidating their active enrollment.
Scope and Policy Details
DetailDME Provider MoratoriumCDS Provider MoratoriumEffective DateAugust 1, 2026August 1, 2026Initial Duration6 months (with option to extend in 6-month increments up to 1 year)6 months (with option to extend in 6-month increments up to 1 year)Geographic ScopeStatewide (All Missouri Counties)Statewide (All Missouri Counties)Impacted EntitiesInitial enrollment applications received on/after August 1, 2026.Initial enrollment applications received on/after August 1, 2026.Exemptions / Existing EnrolleesCurrently enrolled providers are unaffected and may continue servicing participants.Providers whose enrollment application was received by MMAC prior to the implementation date will also not be affected.Currently enrolled providers are unaffected and may continue servicing participants.
Providers whose enrollment application was received by MMAC prior to the implementation date will also not be affected.
If you have questions regarding this notice or for information on enrollment policies, please contact the Missouri Medicaid Audit & Compliance (MMAC) Provider Enrollment Unit by email: MMAC.ProviderEnrollment@dss.mo.gov.
All media inquiries should be directed to Baylee.Watts@dss.mo.gov.
This notice serves as a reminder and education to all HCBS Consumer Directed Services (CDS) vendors regarding requirements for maintaining accurate tax identification information records in Fusion.
Per HCBS Policy 3.25 Appendix 1 and 19 CSR 15-8.400, CDS vendors are required to complete the following for all CDS consumers:
Enter both the Federal Employer Identification Number (EIN) and the Missouri Tax ID directly into the consumer’s record under the “HCBS Eligibility” section in Fusion. Upload proof of EIN to the “Documents” tab under the “EIN Tax Documents” subtype.An audit conducted on June 22, 2026, by the Division of Senior and Disability Services (DSDS) identified significant compliance gaps regarding missing or incomplete EIN and Missouri Tax ID entries in provider records. Missing entries can delay the processing of required information and may interfere with timely service delivery to consumers.
On July 10, 2026, DSDS will be contacting individual CDS vendors with detailed findings from your agency and the required remediation actions. The email will be sent to the business email address listed with MMAC. Vendors must review the consumer records and complete all required corrections no later than August 31, 2026.
Please note that any consumer records not brought into compliance by the deadline will be referred to Missouri Medicaid Audit and Compliance (MMAC) for further administrative action.
The Missouri Medicaid Audit & Compliance (MMAC) Unit is issuing this notice to inform select providers of an upcoming, two-phased off-cycle provider revalidation initiative. This initiative is being undertaken in partnership with the Centers for Medicare & Medicaid Services (CMS), and in consultation with the Office of Governor Mike Kehoe and the MO HealthNet Division (MHD).
This revalidation effort follows Governor Kehoe’s recent communication with CMS regarding enhanced program integrity expectations and federal oversight activities. Governor Kehoe has conveyed Missouri’s commitment to an accelerated revalidation strategy of specific Medicaid provider types to ensure continued compliance with current federal and state screening, enrollment, and program requirements. This off cycle revalidation process is a key component of that strategy and is intended to reduce fraud and strengthen program integrity.
What This Means for Providers MMAC has initiated a two-phase revalidation cycle for selected provider types and individual providers outside of the normal revalidation cycle. Providers selected for this off cycle review will receive the standard 120-, 90-,60-, and 30-day letters via email at the address listed in their eMOMED account. It is the provider’s responsibility to ensure their eMOMED account contact information is up to date. If providers receive a revalidation letter(s) via email, they must revalidate prior to the deadline noted in the letter.Failure to complete the required revalidation steps within the designated timeframe will result in administrative action, including termination as a provider from the MO HealthNet program.
Who Needs to Revalidate Phase I: The following Provider Types shall revalidate prior to October 1, 2026: Adult Day Care providers (Provider ID beginning with “29”) Durable Medical Equipment Suppliers (Provider ID beginning with “62”) Providers without NPIs, Any other provider identified as “high-risk” by CMS or MMAC. Includes Clinics (Provider ID beginning with “50”) with an Autism Center (Specialty code of “AC”) Timeline of events for Phase I: May 4 – May 30, 2026: Public Notice and educational campaign June 1 – Sept. 1, 2026: Monthly 120, 90, 60, 30-day revalidation notices sent to providers. October 1, 2026: Initiation of Administrative Action, including termination, for non-compliant providers.Phase II: The following Provider Types shall revalidate prior to March 2, 2027: Home Health Agencies (Provider Type #s beginning with “58”) Private Duty Nursing (Provider Type #s beginning with “94”) Applied Behavioral Analysts (Provider Type #s beginning with “73”) Hospice (Provider Type #s beginning with “82”) Substance Abuse (Provider Type #s beginning with “86”) Timeline of events for Phase II: Oct. 1 – Oct. 31, 2026: Public Notice and educational campaign Nov. 1, 2026 – Feb. 1, 2027: Monthly 120, 90, 60, 30-day revalidation notices sent to providers. March 3, 2027: Initiation of Administrative Action, including termination, for non-compliant providers.
MMAC appreciates your cooperation and partnership as we implement these measures to safeguard the integrity of the MO HealthNet program and ensure continued compliance with CMS guidelines.
If you have questions regarding this notice, please contact:
Missouri Medicaid Audit & Compliance (MMAC)
Provider Revalidation Unit
mmac.revalidation@dss.mo.gov
573-751-5238
Sincerely,
Richard Ferrari
Director-MMAC
Dear Missouri Medicaid Provider,
The Missouri Medicaid Audit and Compliance Unit (MMAC) is the unit within the Department of Social Services (DSS) responsible for oversight and auditing of compliance with the Medicaid Title XIX, CHIP Title XXI, and Medicaid Waiver Programs in Missouri, which include oversight and auditing of MO HealthNet providers. This includes providers who participate in one of Missouri’s four Managed Care Organizations.
MMAC is notifying you that the Centers for Medicare & Medicaid Services (CMS), through its contractor CoventBridge (USA) Inc. (CoventBridge), may randomly select a number of providers to participate in an upcoming Medicaid integrity audit. CoventBridge, the Unified Program Integrity Contractor (UPIC) for CMS in the Midwest Region, is conducting this audit in consultation with the MO HealthNet Division (MHD) and MMAC.
As part of this process, CoventBridge may request medical records from randomly selected providers to verify claims submitted between October 1, 2023, and September 30, 2025, comply with all applicable federal and state Medicaid laws, regulations, and policies.
The requested records will be used to assess the accuracy of claims and ensure adherence to MO HealthNet policies, including those applicable to providers operating within Managed Care Organizations (MCOs).
Provider Responsibilities:1. Respond to Records Requests:
If you receive a written request from CoventBridge for medical records relating to sampled claims, you are required to respond within the timeframe specified in the request. Timely submission is essential to avoid compliance issues.
2. Legal Compliance:
Under the Deficit Reduction Act (DRA) and other applicable federal and state laws, providers are legally obligated to furnish the requested medical records. Records may be released under HIPAA for Health Oversight Activities authorized by law under 45 CFR 164.512(d). Failure to comply may result in administrative actions as outlined in 13 CSR 70-3.030.
3. Staff Awareness:
Please ensure your administrative staff is aware and understands that correspondence from CoventBridge (USA) Inc. is official and requires prompt attention.
MMAC appreciates your cooperation and your continued commitment to maintaining compliance with Medicaid program requirements.
The Missouri Division of Professional Registration, a division of the Missouri Department of Commerce and Insurance (DCI), is alerting medical providers of a drug trafficking scam targeting doctors and other individuals licensed with the Missouri Board of Registration for the Healing Arts.
The scam involves fraudulent documents claiming a provider’s license has been suspended for illegal drug trafficking and requesting payment of a government security bond via wire transfer.
The documents falsely include official-looking letterhead, seals and stamps from the U.S. Department of Justice and the Missouri Division of Professional Registration Central Investigations Unit. The documents also make fraudulent use of DCI Director Angela Nelson’s signature.
Any unexpected notice of license suspension or a request for payment should be treated as suspicious:
If there is any doubt about the legitimacy of a document or other communication, contact the board at healingarts@pr.mo.gov.
If any provider receives an unexpected communication regarding license suspension due to drug trafficking or otherwise, stop immediately.
Do not submit payment in response to any suspicious communications or requests.
Read the full article on the Missouri Department of Commerce & Insurance (DCI) website.
The first phase of the hard launch of claims validation is scheduled for April 1, 2026. At that time, claims submitted for services requiring EVV and authorized by the Department of Health and Senior Services, Division of Senior and Disability Services (DSDS) (provider types 26 and 28), with no matching visits in the EAS will be denied.
The second and third phases of the hard launch will impact claims for services requiring EVV provided by Home Health Care Service providers (provider type 58) and Department of Mental Health, Division of Developmental Disabilities (DDD) (provider type 85). The timeline for these phases will be provided at a later date.
Since soft launch on January, 7, 2026, MHD, MMAC, DHSS, and MHD have been working with providers offering training webinars, resources, and phone calls to educate providers on upcoming changes.
Additionally, MHD posted a Hot Tip on January 7, 2026 and another Hot Tip posted January 27, 2026.
Providers are encouraged to review their RA to assist in the identification of claims that would be denied following the hard launch. Additionally, 13 CSR 70-3.320 requires all providers to log into the EAS system at least weekly to ensure capture, full functionality, and accuracy of visit data.
For information regarding the EVV claims validation process, visit the EVV website at https://mydss.mo.gov/mhd/evv. For questions, contact Ask.EVV@dss.mo.gov.
