Effective November 1, 2016, DCH will suspend those providers who were sent revalidation letters from HPE between June 1, 2016, and September 1, 2016, and have not submitted a revalidation application.
As noted in the revalidation letter, DCH allowed providers a period of 60 days to revalidate. Those providers who have not revalidated their enrollment within the 60 day time period will be suspended from the Georgia Medicaid/PeachCare for Kids program.
The suspension will apply to providers enrolled in Traditional Fee-for-Service Medicaid, PeachCare for Kids, Georgia Families, and Georgia Families 360° managed care programs which are currently administered by WellCare, Peach State Health Plan, and Amerigroup. Claims for services to members enrolled in Traditional Fee-for-Service Medicaid, PeachCare for Kids, Georgia Families, and Georgia Families 360° managed care programs for dates of service on or after November 1, 2016, will not be paid.
Upon successful revalidation, your suspension will be lifted. However, your effective date will be the date you revalidated. Retro-enrollment is not applicable in this instance. Should you fail to revalidate your enrollment within thirty days of receipt of the suspension letter, you will receive a notice of termination from DCH. The notice of termination will outline your appeal rights.
A report of those providers who have not submitted a revalidation application can be found on GAMMIS at www.mmis.georgia.gov. Click on Provider Information/Provider Notices. Providers who are on this report who have not submitted a revalidation application by November 1, 2016, will be suspended.
The Frequently Asked Questions (FAQ) regarding revalidation can be found on GAMMIS at www.mmis.georgia.gov. Click on Provider Information/FAQ for Providers. In addition, providers may contact Medicaid’s fiscal agent HPE at 800-766-4456 (Option #1) or email DCH at RevalidationEnrollment2@dch.ga.gov for assistance.