OPR providers required to revalidate their IHCP enrollment

The Centers for Medicare & Medicaid Services (CMS) recently provided guidance clarifying that ordering, prescribing, and referring (OPR) providers must revalidate their Medicaid enrollments at intervals not to exceed every five years. Accordingly, the Indiana Health Coverage Programs (IHCP) is requiring enrolled OPR providers to revalidate based on their initial enrollment date.

OPR providers will receive notification with instructions for revalidating in advance of the revalidation deadline. Providers that fail to revalidate in a timely manner will be disenrolled from the IHCP and must re-enroll to participate. Notices will be sent to the mailing address on the OPR provider's enrollment file. It is important to keep address information up-to-date to ensure delivery of these notices.

OPR providers will revalidate using the paper IHCP Ordering, Prescribing, or Referring Provider Enrollment and Profile Maintenance Packet. Note that OPR providers are not required to pay an enrollment fee at revalidation. The OPR providers are also considered limited-risk providers which simplifies the revalidation screening process.

For more information about the revalidation process, see the following references: