Provider Enrollment Revalidation

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The South Carolina Department of Health and Human Services (SCDHHS) is required to revalidate providers' enrollment information in accordance with the Patient Protection and Affordable Care Act (PPACA) provider enrollment and screening regulations published by the Centers for Medicare and Medicaid Services (CMS).

Providers enrolled in the South Carolina Healthy Connections Medicaid program must have their enrollment revalidated by SCDHHS on or before March 25, 2016. In the upcoming months, SCDHHS will notify providers when to begin the revalidation process and the specific date by which the provider's enrollment must be revalidated. Providers should not take any steps to revalidate their enrollment until they receive an official notification letter from SCDHHS.

Per CMS regulations, an enrollment application fee is required for revalidation. SCDHHS will collect the applicable application fee prior to revalidation. The application fee applies to business organizations and entities that enroll in South Carolina Healthy Connections Medicaid with an Employer Identification Number (EIN). The application fee does not apply to:

  1. Individual physicians (sole proprietors enrolling with a Social Security Number (SSN) and EIN are considered individuals)
  2. Non-physician practitioners
  3. Providers who are enrolled in Medicare and/or enrolled in another state's Medicaid agency or Children's Health Insurance Program (CHIP)
  4. Providers who have paid the applicable application fee to Medicare and/or another state's Medicaid or CHIP

 

SCDHHS' goal is to continue to enhance the integrity of the South Carolina Healthy Connections Medicaid program while complying with federal requirements. If you have any questions regarding provider revalidation, please contact the Provider Service Center at (888) 289-0709, option 4.

Thank you for your continued support of the South Carolina Healthy Connections Medicaid program.

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