MISSOURI RECEIVES APPLICATION FEE WAIVER FOR CERTAIN PROVIDER TYPES

 

State and federal regulations (13 CSR 65-2 and 42 CFR 455.460) require MMAC to collect an application fee, currently set at $542.00, from all new and revalidating “institutional” Medicaid providers.  “Individual” providers such as physicians, dentists and other individual non-physician practitioners are not required to pay the application fee.

 

Effective July 1, 2015, MMAC began collecting the required application fee from all new, reenrolling and revalidating MO HealthNet institutional providers.

 

Providers can request a hardship waiver of the application fee from CMS, but the fee must be submitted before the application will be processed by MMAC.  If CMS approves the hardship waiver, MMAC will refund the application fee to the provider. Click here for more information regarding requesting a hardship waiver from CMS.

 

Providers who paid the $542 fee to Medicare or another state Medicaid agency will be exempt from paying an application fee.

 

The only providers who will be paying the required application fee during state fiscal years 2016 and 2017 (July 1, 2015 to June 30, 2017) will be newly enrolling institutional providers.

 

There are various payment options for providers that are required to submit the application fee during state fiscal year 2016 and state fiscal year 2017:

 

You may pay electronically using a credit card, debit card or e-check through the contracted state vendor, Collector Solutions.  A convenience fee will apply, depending on the form of electronic payment selected. Click here for Collector Solutions website. The vendor will provide a receipt reflecting the application fee was paid which can be submitted to MMAC with your application. Providers also have the option of submitting a cashier’s check or money order, made payable to DSS-MMAC Application Fee.  Cash and personal/business checks will not be accepted.  Mail your check to: For more information about hardship waivers, please click here.

 

On August 14, 2015, MMAC received an exemption waiver from CMS for several provider types, when the provider is publicly funded. Click here to read the letter.  Specifically, the waiver applies to government-operated providers which are publicly funded, such as those operated by city, municipal, county, and state agencies.  As of this date, this applies to all 325 enrolled school-based services providers, all 104 enrolled public health departments, all 13 enrolled long term care state institutions, and all three (3) enrolled state mental hospitals.  It also applies to some providers in other categories. If you are uncertain whether this applies to you, please contact MMAC at mmac.providerenrollment@dss.mo.gov or by calling (573) 751-8619.  If this waiver does not apply to you, you may still request a hardship waiver directly from CMS.

 

 

If you have any questions regarding whether or not the exemption covers you, please contact MMAC at MMAC.ProviderEnrollment@dss.mo.gov or at 573-751-3399 (request provider enrollment.)

Providers who self-audit and discover overpaid amounts are able to “self-disclose” or report those findings.  The findings, along with repayment, can be sent to Missouri Medicaid Audit & Compliance (MMAC) by using the Self Disclosure Form, located here.  Providers do not have to submit multiple checks, as the form allows for a detailed, line-item description of the amount(s).  Submitting one check per disclosure form (for multiple disclosures) is preferable.