Promoting and protecting the health and safety of all Idahoans

Provider Enrollment Applications

All providers wishing to participate in the Idaho Medicaid Program must first register for a Trading Partner Account (TPA) at Select “Register” in the upper right hand corner to complete the TPA registration.  Once complete,  follow the link for the Provider Enrollment Application after logging in. A complete application includes a Medicaid Provider Enrollment Agreement and a W9, which must be signed by the provider and submitted with the enrollment application along with other attachments through the website to Molina.  If you need additional assistance in completing the application, call 1-866-686-4272.

Provider Screening and Enrollment

States are required to revalidate all provider enrollments at lease every five years. Providers will be notified when their provider type is scheduled for revalidation. 

New federal regulations established by the Centers for Medicare and Medicaid Services (CMS) in 42 CFR 455, Subpart B require enhanced screening and revalidation for all existing (and newly enrolling) providers. These regulations are designed to increase program integrity and quality of care.

To meet these requirements Idaho Medicaid is making significant changes to provider enrollment policies and procedures. The enhanced enrollment activities are required for all initial enrollments, revalidation of enrollment status, change of ownership, new locations, and re-enrollments.

Idaho has implemented enhanced screening measures including but not limited to disclosures, federal database checks, and licensure screening.

Watch the MedicAide newsletter and the Idaho Medicaid Portal for more information about other changes and enhancements to the provider enrollment/revalidation process.