Medicaid Provider Terminations Resumed on January 23rd for Failure to Complete Medicaid Agreement Revalidations in the PNM

The Ohio Department of Medicaid (ODM) has resumed terminations effective January 23, 2024, for enrollees who fail to complete the Medicaid Agreement Revalidation in the Provider Network Management module.

If your staff are currently due for a revalidation in the Provider Network Management (PNM) module, it is imperative that you take immediate action to complete and submit the revalidation application to renew the Ohio Medicaid Provider Agreement.

ODM resumed provider revalidation notices in June 2023 as part of the federally required unwinding process from the COVID public health emergency (PHE). ODM issues a series of notices to the provider’s primary contact listed in the PNM, with the first one delivered 120 days prior to the provider Medicaid agreement end date. Subsequent reminders are issued at 90 days, 60 days, and a final notice at 30 days. If you receive a revalidation notice, it is imperative that you take action to complete the revalidation on time. All providers are subject to either three-or-five-year time limited provider agreements.

How do you know if you are due for revalidation?
Check your email. Revalidation notices are posted in the PNM module and can be accessed in the Correspondence folder. Please be sure to select the type of correspondence from the drop down (in this case “Enrollment Notices”), and search for the “Revalidation Notices.” Review the Accessing Communications within PNM Quick Reference Guide for step-by-step instructions.

Please note: If you think a provider is due for revalidation but have not received notices, please login to the PNM module and verify that the primary contact information is accurate. All mailers and email notices are directed to the primary contact individual or address identified in the system.

If due for revalidation, what action do I need to take?
A “Begin Revalidation” option appears in the PNM Enrollment Action Selections 120 days prior to the Medicaid Agreement end date. This can be found under the “Manage Application”, “Enrollment Actions” option within the provider file. Review the Revalidation/Reenrollment Quick Reference Guide for step-by-step instructions.

For technical support or assistance, contact ODM’s Integrated Helpdesk (IHD) at 800-686-1516 and follow the prompts for Provider Enrollment (option two, option two) or email [email protected]. Representatives are available Monday-Friday, 8am – 4:30pm.

To learn more about the PNM module and Centralized Credentialing, visit the PNM and Centralized Credentialing page on the Next Generation website.