Recently, Missouri Medicaid Audit and Compliance (MMAC) learned that not all providers are aware that the Missouri Medicaid Audit & Compliance Title XIX Participation Agreement was updated effective March 15, 2025. Section six (6) of the agreement was updated to reflect providers are required to maintain records for six (6) years, as required by regulations, instead of five (5) years documented in the previous agreement.
All updated documents and requirements for each specific provider type can be found at the following link: https://mmac.mo.gov/revalidation-requirements/.
MMAC recommends providers use the revalidation requirements link https://mmac.mo.gov/revalidation-requirements/, when completing a new enrollment or revalidation. Using the link will ensure all correct forms are being used instead of relying on older, outdated forms that may have been saved to a local computer. Using the link and correct forms will prevent rejections of enrollments/revalidations due to old documents being used, which will lead to a more timely and efficient approval process.
Any questions can be sent to mmac.revalidation@dss.mo.gov or by calling (573) 751-5238.
MMAC appreciates your collaboration and partnership. We thank you for the critical services you provide to our Medicaid community.
Sincerely,
Richard Ferrari,
Director-MMAC
Beginning January 1, 2018, according to federal regulation 42 CFR 438.602, states must screen and enroll, and periodically revalidate, all network providers of managed care organizations. This requirement applies to ordering, prescribing, and referring “OPR” providers in the managed care setting, as well.
This requirement does not cause managed care network providers to see Fee For Service Medicaid clients.
Missouri Medicaid Audit and Compliance (MMAC) is working with the MO HealthNet Division and the managed care health plans to provide a streamlined process for enrolling managed care network providers that have not yet enrolled with MO HealthNet.
Please submit any questions you may have to MMAC.ProviderEnrollment@dss.mo.gov
The Missouri Medicaid Audit and Compliance Unit (MMAC) enrolls MO HealthNet Fee for Service providers. Many providers utilize credentialing agencies to submit their enrollment paperwork and any subsequent updates. All enrollment approvals and updates are confirmed when MMAC sends an automated Approval Letter to the credentialing agency.
MMAC encourages the credentialing agencies to retain the approval letters. This will streamline efforts when the agencies wish to review their enrolled provider group and the corresponding dates of approval.
In order to facilitate the enrollment process, please fax all documentation other than the “signature” page to (573-751-5065) or you may scan and email the verification documentation to mmac.providerenrollment@dss.mo.gov, which may include tax documents, Medicare enrollment verification, Board of Healing Art licensure, or other verification documentation for enrollment. The Provider Enrollment Unit also has an auto-responder that confirms the receipt of the e-mail. “Signature Pages” MUST still be faxed to (573-634-3105) until further notice.
MMAC is responsible for administering and managing Medicaid (Title XIX) audit and compliance initiatives and managing and administering provider enrollment contracts under the Medicaid program. MMAC is charged with detecting, investigating and preventing fraud, waste and abuse of the Medicaid Title XIX, CHIP Title XXI, and waiver programs. For additional information about MMAC visit their website at https://mmac.mo.gov/.
