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February 21, 2017
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Providers - Medicaid
MEDICAID INFORMATION RELEASE 2005-38
posted on March 02, 2009 12:18
December 1, 2005
MEDICAID INFORMATION RELEASE 2005-38
Providers of Mental Health Clinic and Psychosocial Rehabilitation Services
Leslie Clement, Deputy Administrator
SUBJECT: ADDITIONAL TERMS to the MEDICAID PROVIDER AGREEMENT
Medicaid is updating its Provider Agreement with Mental Health Clinic and Psychosocial
Rehabilitation providers in order to ensure that all providers are operating under standard terms and conditions statewide. This should eliminate the confusion regarding which version of the Medicaid Provider Agreement is in effect. Additional Terms are now incorporated into the Medicaid Provider Agreement. The updated Provider Agreement will replace all existing Provider Agreements held by Mental Health Clinic providers and Psychosocial Rehabilitation providers and will replace all existing Supplemental Service Agreements now held by Psychosocial Rehabilitation providers.
See page 2 for important dates and activities.
Psychosocial Rehabilitation Agencies
Psychosocial Rehabilitation Agency providers will need to sign a separate Provider Agreement for each physical location. A physical location is an agency office or building used by facility staff to meet with or provide services to participants. For each subsequent location, a provider application must be completed so a unique provider number can be issued for each physical location. The provider agreement will cover services for both adults and children. A single physical location that serves both adults and children will sign one Provider Agreement and be issued one provider number. There will no longer be a requirement for separate Provider Agreements for serving adults and children.
Mental Health Clinics
Currently, the Department must approve the physical location of each Mental Health Clinic prior to the provider delivering services at that site. A separate provider agreement will now need to be signed for each Mental Health Clinic location, and a separate provider application completed for each subsequent clinic location so a unique provider number can be issued. Locations not approved by the Department prior to January 1, 2006, must apply and obtain approval through the new Credentialing Program prior to providing Medicaid services at that site.
The new Provider Enrollment Applications and Agreement will be available December 5, 2005 at
under Medicaid Provider Information.
Please direct all inquiries regarding this announcement to Pat Guidry at (208)364-1844 or
Important Dates and Activities
December 5, 2005
New Provider Agreements are mailed to Clinic and PSR providers.
Providers should read and sign the new Provider Agreement to remain active in the Medicaid program.
January 1, 2006
Last date Medicaid will process requests from existing clinic providers for approval of additional clinic locations. Providers are responsible for ensuring additional clinic location applications are submitted sufficiently in advance of this date in order for the Department to have time to review them by this date.
Any clinic location that is not registered with the Department by this date will be referred to a waiting list and will be reviewed for approval or disapproval through the new Credentialing process later in 2006.
January 14, 2006
Providers must sign new provider agreements and mail to EDS. The signed new agreements must be received by EDS no later than this date.
To prevent a disruption in the provider’s ability to bill and receive reimbursement for delivered services, the provider must ensure EDS receives the signed new agreement by this date.
January 15, 2006
Agreements received on this date or later will be returned to the provider.
If EDS has not received the signed new agreement before this date the provider must re-apply to be a Medicaid provider of mental health services through the new Credentialing Program.
January 21, 2006
Existing Provider Agreements will be end-dated.
Last date providers can deliver Medicaid services under the existing Provider Agreement and obtain reimbursement for them.
January 31, 2006
Last date Provider Applications for new PSR or Clinic agencies will be accepted.
Applications for new agencies received after this date will be returned to the provider applicant. A new provider application will be developed and made available through the Credentialing Program in March.
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