All MO HealthNet providers are required by state regulations to disclose certain information to Missouri Medicaid Audit & Compliance (MMAC) during their initial enrollment or revalidation processes. Those mandatory disclosures include:
- The name, address, date of birth, social security number, or other tax identification number of any person with a five percent (5%) or more ownership or control interest in the applying provider and any subcontractors in which the applying provider has a five percent (5%) or more interest;
- Whether any person with an ownership interest in the applying provider is related to another person with ownership or control interest in the applying provider as a spouse, parent, child, or sibling;
- Whether any person with an ownership or control interest in any subcontractor in which the applying provider has a five percent (5%) or more interest is related to another person with ownership or control interest in the applying provider as a spouse, parent, child or sibling.
- The name, address, date of birth and social security number of any managing employee of the applying provider.
Disclosures must be updated within thirty-five (35) days of any changes in information required to be disclosed.
MMAC is required to collect the disclosed information to screen individuals and legal entities with ownership and control interest against various state and federal exclusion databases.
Please review 13 CSR 65-2.020 for more information or email MMAC.ProviderEnrollment@dss.mo.gov if you have questions.