Provider Reverification Requirements to be Reinstated at End of Federal Health Emergency CMS requires that all Medicaid providers are recredentialed
When the federal Public Health Emergency (PHE) reaches its end point, so does the suspension of reverification activities for providers enrolled in NC Medicaid. It is expected that later this year, providers will begin receiving reverification notices. Notices will be sent to providers with approaching reverification due dates, as well as those whose reverification was suspended during the PHE.
The Centers for Medicare and Medicaid Services (CMS) requires that all Medicaid providers are recredentialed, a process also referred to as reverification. Since March 2020, CMS has allowed for the suspension of reverification due to the PHE caused by COVID-19. However, when the period of suspension expires, NC Medicaid must ensure enrolled providers are compliant with the reverification requirement.
- Providers will receive a reverification notice in their Message Center Inbox on the secure NCTracks Provider Portal when reverification is due.
- Due dates for reverification are specific to each provider, therefore not all providers will be receiving notices simultaneously. Providers have 45 days after notification to complete the reverification process.
- NC Senate Bill 105 Session Law 2021-180 Section 9D.9(a) temporarily waived the $100 fee for Medicaid enrollment and reverification through June 30, 2023.
Reverification is not optional. Providers who receive a notice of reverification are encouraged to promptly respond and begin the online process. Providers who do not complete the process timely will receive a Notice of Suspension via postal mail and in their NCTracks Message Center Inbox. The notice informs the provider that they are in suspended status, which will cause all NC Medicaid Direct and NC Medicaid Managed Care claims to pend.
- Providers have 30 days following notification of suspension to complete reverification.
- Those who do not comply will be subject to termination from the NC Medicaid program.
- Reverification does not apply to any time-limited enrolled providers, such as out-of-state (OOS) providers, who choose to enroll annually.
An updated Active Provider Recredentialing Due date spreadsheet will be made available once the reverification process is re-initiated. Providers will begin receiving a recredentialing/reverification invitation through the NCTracks secure portal once they are scheduled to begin the process. Providers should continue to monitor their secure NCTracks Message Inbox for notifications and review the availability of the reverification application in the appropriate section of their NCTracks Status and Management page.
For help with the reverification process, providers can refer to the Provider Re-credentialing/Re-verification webpage in the NCTracks provider portal. Providers are also encouraged to review Provider Announcements, User Guides and Frequently Asked Questions.
NCTracks Call Center: 800-688-6696