All MO HealthNet Providers Responsible for Updates
January 6, 2025
All enrolled MO HealthNet providers are responsible for keeping their information up to date with the Missouri Medicaid Audit and Compliance (MMAC) Unit, as required in 13 CSR 65-2.020. All changes must be reported to MMAC by using the Provider Update Request.
MMAC has redesigned the Provider Update Request for the ease of providers. Beginning February 1, 2025, providers must use this new form to make any changes to their MO HealthNet enrollment; the previously used form will no longer be accepted.
Once completed, the form and any accompanying documents must be faxed to 573-634-3105.
Changes include but are not limited to:
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The provider must consider the following when submitting the Provider Update Request to MMAC:
- MMAC only accepts either an ink signature or one of the approved electronic signatures on all MMAC forms
- The individual provider’s signature is required for the following updates:
- Main practice location update
- Provider is updating enrollment from a billing provider (03) to a performing provider (13)
- Change in the Pay To information (Providers must also complete the Electronic Funds Transfer Authorization Agreement)
- For a group or clinic, the individual signing the Provider Update Request must be authorized personnel listed with MMAC on the provider’s ownership as a managing employee or an owner
- MO HealthNet providers may update an additional practice location in eMOMED, excluding the following:
- Advanced Nurse Practitioners
- Ambulatory Surgery Center
- Dialysis Clinic
- Federally Qualified Health Center
- Provisionally licensed counselors
- Rural Health Clinic
These providers must update an additional practice location by using the Provider Update Request.
If the provider is having technical issues with adding or removing an additional practice location in eMOMED, contact the eMOMED Helpdesk at (573) 635-3559.
Contact MMAC Provider Enrollment at MMAC.ProviderEnrollment@dss.mo.gov for all other questions.