21 Century Cures Act

Dear Provider,

As a reminder, effective January 1, 2018, the 21st Century Cures Act (Public Law 114 255) requires all Medicaid managed care network providers to be enrolled with the state Medicaid program. This requirement applies to all providers participating in Medicaid Managed Care Organizations (MCOs).

In addition, pursuant to 42 CFR § 455.414 – Revalidation of Enrollment, state Medicaid agencies are required to revalidate the enrollment of all Medicaid providers, regardless of provider type, at least once every five (5) years. Compliance with both enrollment and revalidation requirements is mandatory in order to maintain participation in a Medicaid managed care network.

Failure to obtain a Medicaid ID, revalidate an existing Medicaid ID, or complete the required 21st Century Cures Act enrollment process may result in termination from the WellCare Health Plan / Fidelis Care provider network, in accordance with state and federal guidance outlined in applicable Medicaid Newsletters.

Important Notice for Existing Providers

Existing providers who do not comply with Medicaid enrollment or revalidation requirements within 150 days of this notice will be terminated from the WellCare Health Plan / Fidelis Care provider network.To safeguard your participation, all providers must take one of the following actions:

• Submit a new Medicaid enrollment application, or
• Revalidate your existing Medicaid ID, if you are already enrolled

Please note: All providers must complete the 21st Century Cures Act Provider Application, even if your specialty is deemed “Ineligible” by DMAHS.

How to Enroll or Revalidate Your Medicaid ID

New Enrollment / 21st Century Cures Act Application

1. Visit www.njmmis.com
2. Select “Provider Enrollment Applications”
3. Choose “21st Century Cures Act Application” as the Provider Type

Ways to submit your completed application:

• Mail: Gainwell TechnologiesProvider Enrollment Unit
  P.O. Box 4804
  Trenton, NJ 08650
• Fax:1 609 584 1192

For enrollment questions, please contact the Gainwell Technologies Provider Enrollment Unit at 1 609 588 6036.

Provider Revalidation Requirements (§ 455.414)

Active providers submitting a Provider Enrollment Package for Revalidation must complete the following steps:

1. Review the Revalidation Instructions and obtain the Revalidation Cover Page
2. Attach the Revalidation Cover Page to the appropriate Provider Enrollment Package (selected from the NJMMIS enrollment dropdown)

Important: Revalidation requests cannot be processed without the Revalidation Cover Page attached.

For questions regarding the revalidation process, please contact:

Gainwell Technologies – Revalidation Unit
1 833 909 1522
Monday–Friday, 8:00 AM – 5:00 PM