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On February 21, 2024, Change Healthcare had a problem with cyber security. If you were affected by this, you will get a letter in the mail. To learn more, you can click here or call the contact center at 1-866-262-5342.

DCH Provider Revalidation Notice

Date: 08/17/23

Dear Medicaid and PeachCare for Kids Providers:

Federal regulations require State Medicaid Agencies to revalidate the enrollment of all providers, regardless of provider type, at least every five years (42 CFR 455.414). The revalidation process requires an enrolled provider to confirm the accuracy of its enrollment information and to make corrections where appropriate. DCH requested and received a temporary waiver of this requirement during the national Public Health Emergency (PHE). The national Public Health Emergency ended on May 11, 2023. Accordingly, providers that have not complied with federal regulations are required to complete the revalidation process by September 15, 2023.

The Department has identified several providers that have not revalidated their enrollment in accordance with federal regulations. A complete listing of the providers who have not submitted a revalidation application can be found online on the GAMMIS website at www.mmis.georgia.gov. Once you reach the landing page, select the “Provider Information” tab at the top of the page. Then select “Reports for Public Access.” Select the report titled “Provider Revalidation Past Due by Provider Type.”  Providers who are listed on this report will be suspended if they do not revalidate their enrollment by September 15, 2023.  

Effective September 16, 2023, DCH will suspend the enrollment of those providers who have failed to revalidate their enrollment.  As a result, suspended providers will not be able to participate in the Georgia Medicaid/PeachCare for Kids programs.  The suspension will apply to providers serving Traditional Fee-for-Service Medicaid members, PeachCare for Kids members, and the Georgia Families and Georgia Families 360 managed care programs which are administered by Amerigroup, CareSource, and Peach State Health Plan.  Claims with dates of service on or after September 16, 2023, will not be paid.

Upon successfully completing the revalidation process, your suspension will be lifted. However, your effective date will be the date that you submit your revalidation application. Retro-enrollment is NOT applicable in this instance. Should you fail to revalidate your enrollment within thirty (30) 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.

The Frequently Asked Questions (FAQs) regarding revalidation can be found on the GAMMIS Website. Click on the Provider Information tab at the top of the screen. Select FAQ from the drop-down menu. Providers may also contact Gainwell Technologies for assistance at 800-766-4456.