Illinois Announces More Frequent Medicaid Provider Organization Revalidation

The Centers for Medicare & Medicaid Services (CMS) has instructed states to require additional provider organization revalidations beyond those already scheduled. Provider organizations in affected categories will need to revalidate within an upcoming two-year cycle rather than on the standard five-year schedule.

The change does not apply to provider organizations who revalidated or enrolled within the 12-month period from April 30, 2025, through April 30, 2026. Affected categories include high-risk provider organizations, provider organizations without a National Provider Identifier (NPI), laboratory provider organizations, and Applied Behavior Analysis (ABA) provider organizations.

Previously, CMS required all actively enrolled . . .