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.