Program BackgroundSection 6401 (a) of the Affordable Care Act (ACA) established a requirement for all enrolled providers and suppliers to revalidate their enrollment information under new enrollment screening criteria. This revalidation initiative applies to those providers and suppliers who were enrolled on or prior to December 31, 2012. Providers who were enrolled as of January 1, 2013, will be required to revalidate their enrollment in the second phase of this process no later than December 31, 2018. They will receive their revalidation notice at a later time.
Hewlett-Packard Enterprise Services (HP) began mailing notices to initiate the revalidation process for each provider and supplier in June 2014 and will conclude on December 31, 2015. Providers and suppliers must not begin the revalidation process prior to notification by HP. Please note that 42 CFR 424.515(d) authorizes the Georgia Department of Community Health (DCH) to conduct off-cycle revalidations.
Action RequiredProviders will have sixty (60) days from the date of their revalidation letter to complete the revalidation process. Providers must complete revalidation timely or their Georgia Medicaid Fee-For-Service and Georgia Families/Georgia Families 360° program participation will be suspended and subsequently, your enrollment with WellCare of Georgia will be suspended or terminated. During this suspension period, claims will not be paid.
In an effort to improve efficiency and timeliness of the revalidation process, DCH requires all providers to revalidate online only using the Georgia Medicaid Management Information System (GAMMIS) at www.mmis.georgia.gov. The use of paper applications is prohibited during the revalidation process. The revalidation process will require minimal data input and will focus on verification of a provider's current enrollment status. Providers will be required to verify their name, date of birth, Social Security Number, NPI, Tax ID number and license numbers. Most providers should be able to complete the revalidation process in approximately 20 minutes or less.
Access the GA Revalidation FAQ (Frequently Asked Questions).
If there is a possibility you have not revalidated your Georgia Medicaid enrollment, please visit GAMMIS Provider Notices to review the latest active listing and take immediate actions if your name/organization is recorded. In the event your revalidation letter was not received, confirm the mailing address and/or email address on file with HP. If your preferred contact information is incorrect, access your GAMMIS account to update or submit to HP the Medicaid Peachcare Provider Information Change form to prevent future mailing issues. The deadline for provider revalidation to prevent suspension from the aforementioned Medicaid programs was April 1, 2015.