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06/25/2019

Enforcement of Medicaid Provider Enrollment Requirements

Key Takeaway: If you see Medicaid patients, you must enroll in CHAMPS, or your patients will not receive prescriptions or have orders approved. This applies to all providers that bill in your practice

Key Takeaway: If you see Medicaid patients, you must enroll in CHAMPS, or your patients will not receive prescriptions or have orders approved. This applies to all providers that bill in your practice. Enrolling in CHAMPS does not require you to take new Medicaid patients.

Medicaid has published several bulletins regarding the compliance with 42 CFR 438.602(b) and Section 5005(b)(2) of the 21st Century Cures Act. Compliance requires any individual or entity that provides services to, or orders, prescribes, refers or certifies eligibility for services for, individuals who are eligible for medical assistance under the Michigan Medicaid State Plan participating in a managed care entity’s provider network must be screened and enrolled in the Michigan Medicaid Program.

Please read and comply with Bulletin 18-47 or you will be risking reimbursement and possible necessary services/drugs/supplies for your patients.

Here is a direct link for you: https://www.michigan.gov/documents/mdhhs/MSA_18-47_639604_7.pdf

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