Utah Admin. Code R414-23-3 - Revalidation Requirements
(1) An enrolled
provider must revalidate with Medicaid through PRISM at intervals not to exceed
five years as required by
42
CFR 424.515, depending on the provider 's risk
level.
(2) The Department shall
notify a provider , when it is time to revalidate, with a letter mailed to the
pay-to address in the PRISM system.
(3) A provider must complete and submit the
revalidation process within 60 days from the date of the letter, or the
Department will place a temporary payment hold on the provider
account.
(4) The Department shall
terminate a provider that fails to revalidate within 90 days from the date on
the letter. The provider , however, has the option to request a fair
hearing.
(5) A provider terminated
for any reason must reenroll and be approved as a new provider .
(6) The Department may only reimburse a
provider for services rendered during an enrollment period.
Notes
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