The Centers for Medicare and Medicaid Services (CMS) mandates State Medicaid Agencies to validate/revalidate ALL of its Medicaid Providers’ enrollment every 5 years
Collecting and maintaining these requirements, designed to prevent provider fraud, waste and abuse, as well as improve patient safety may be delegated by the State to a PBM or payer network plan. Regulations also state that screening must be performed consistently and redundant screening is not conducted for a pharmacy provider who participates in multiple networks. resQ™ Pharmacy Credentialing Resource makes it easier for Medicaid organizations and payers to gather and comply with these regulations.
CMCS Informational Bulletin