May 2015

Volume 4, Issue 3

DCH-i Masthead
 
Termination of Providers Who Have Not Submitted a Revalidation Enrollment Application

Dear Providers,

The Affordable Care Act mandates that states revalidate the enrollment of all providers every five (5) years. Beginning in April 2014 and monthly thereafter, DCH and Hewlett-Packard Enterprise Services (HPES) sent letters to providers requiring that they revalidate their enrollment within 60 days of the date on the letter. A significant number of the letters mailed to providers noted above were returned to HPES. It is critical that providers ensure that their mail-to-address is correct in the Georgia Medicaid Management Information System (GAMMIS). Providers can review or update their mail-to address information by logging into GAMMIS and clicking on Demographic Maintenance.

On April 1, 2015, DCH suspended those providers who had a deadline to revalidate their enrollment from June 1, 2014 through October 1, 2014 and failed to comply. Notices were sent to those providers that were suspended. On June 1, 2015, DCH will terminate those providers who were suspended on April 1, 2015, that have not submitted a revalidation enrollment application by May 30, 2015.

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Georgia Medicaid Paperless Hard Stop was May 1

The Georgia Paperless Initiative launched on September 1, 2014, between the Georgia Department of Community Health (DCH) and DCH's fiscal agent (partner vendor) Hewlett-Packard Enterprise Services (HPES). DCH and HPES teamed up to transition to a paperless system for Medicaid provider enrollment, claims filing, appeals and reimbursement. In 2015, the Paperless Initiative will be implemented in phases. 

The Initiative for Phase 1 began with the rollout of online-only enrollment for institutional providers. The Provider Enrollment (PE) process is now online. Provider Enrollment applications and any download of supporting documents can be submitted through the GAMMIS Web Portal via a secure login under the PROVIDER ENROLLMENT (PE) hyperlink. You can contact the PE team at Contact Us or call HPES at (800) 766-4456. Any applicable documents can be faxed to the PE team at (866) 483-1045.

ALL claims, appeals, forms, prior authorizations (PA) and PE documents are to be submitted electronically through the GAMMIS Web Portal, www.mmis.georgia.gov. Effective May 1, 2015, paper will no longer be accepted from institutional and individual providers into the HPES web portal. 

DCH Voluntary Long-Term Care Background Check Program

In August 2012, the Department of Community Health (DCH) received a grant from the Centers for Medicare & Medicaid Services (CMS) to:

  • Help Georgia protect vulnerable populations in long-term care settings;
  • Identify efficient, effective and economical procedures for Georgia to conduct State and Federal background checks; and
  • Establish a framework for standardized nationwide program for Georgia to conduct fingerprint-based background checks on all prospective direct patient access employees of long-term care facilities and providers.
As mandated by Georgia law, DCH currently conducts state and national fingerprint checks of owners and directors of personal care homes and assisted living communities, as well as the owners of private home care providers and community living arrangements. Georgia law also requires that employees of personal care homes, assisted living communities and nursing homes undergo a State background check; however, a national or Federal Bureau of Investigations (FBI) fingerprint check is not mandated.

2015 Board Meeting Schedule

The Board of Community Health will meet next on Thursday June 11, 2015. To view the entire DCH Board meeting schedule for 2015, as well as actions taken at previous DCH Board meetings, click HERE.

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In This Issue
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About DCH-i  

  

DCH-i is the monthly newsletter from the Georgia Department of Community Health for all matters DCH. It provides timely and important information to you as physicians, dentists, hospitals, third-party payers, vendors, health care advocates, consumers and legislators. Our goal is to help create A Healthy Georgia -- together. Write us at

DCH-i@dch.ga.gov.

 

 

Do you have a question  
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About DCH

 

2 Peachtree

 

Through effective planning, purchasing and oversight, the Department of Community Health (DCH) provides access to affordable, quality health care to millions of Georgians, including some of the state's most vulnerable and underserved populations.

 

 DCH is responsible for Medicaid and PeachCare for Kids,? the State Health Benefit Plan, Healthcare Facility Regulation and Health Information Technology in Georgia.      

 

Clyde L. Reese III is the DCH Commissioner.  

 

We are dedicated to
A Healthy Georgia
.   

   

www.dch.georgia.gov 

 

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DCH-i

    

Editor-in-Chief

Jeremy Arieh

 

Circulation

Janice Abrams 

 

Director of Communications

and Legislative Affairs

Lisa Marie Shekell

 

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DCH logo in reverse 

    

DCH Mission

 

We will provide Georgians with access to affordable quality health care through effective planning, purchasing and oversight.

 

 

We are dedicated to 
        A Healthy Georgia.

      

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