Provider Self-Disclosures

Missouri Medicaid Audit & Compliance encourages providers and entities to establish and implement compliance integrity plan. MMAC also encourages providers and entities to self-disclose or report those findings along with funds to compensate for the errors or a suggested repayment plan, which requires MMAC approval, to the Financial Section of MMAC at the address below:

Missouri Medicaid Audit & Compliance
Financial Section – SELF DISCLOSURE
P.O. Box 1116
Jefferson City, MO 65102


NOTE: DMH providers wishing to report ISL or Shared Relief variance hours SHOULD NOT use the Self Disclosure form.  Please  CLICK HERE for more information.

In an effort to ensure Provider Initiated Self Disclosures are processed quickly and efficiently please reference the provider initiated Self Disclosure Form. Make sure to complete the form and include the participant’s name and DCN, Date of Service, Internal Control Number (ICN), Paid Amount, Refund Amount and Reason for Refund. Providers can direct questions regarding Self Disclosures to the MMAC Financial Section at or by calling 573-751-3399.