Providers are Required to Revalidate Enrollment Information (IB 25-14)

Date: 04/23/25

Louisiana Healthcare Connections is sharing a with providers that they are required to revalidate enrollment information per IB 25-14.

Per 42 CFR § 455.414, all Medicaid-enrolled providers, including ordering or referring providers, must revalidate their enrollment information, regardless of provider type, at least every five years. However, durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) providers must revalidate their information every three years to maintain their participation in Louisiana Medicaid.

When revalidating a provider's enrollment, a full screening appropriate to the provider’s risk level is conducted. The risk-based screening requirements under 42 CFR § 455.450 apply to newly enrolling and revalidating providers.

Revalidation includes the disclosure requirements specified in 42 CFR § 455.104, § 455.105, and § 455.106, and, depending on the provider’s risk level, includes site visits and fingerprint-based criminal background checks.

Providers will receive an email from the Louisiana Medicaid Provider Enrollment web portal and a letter via the U.S. Postal Service informing them that it is time to revalidate their enrollment records. Providers can also find their revalidation due date or track their status by accessing the Provider Lookup Tool at https://www.lamedicaid.com/portalenrollmentstatus/search.

Providers within the revalidation period who have not received an email alert or letter should contact Gainwell Technologies at louisianaprovenroll@gainwelltechnologies.com or by calling 1 (833) 641-2140.

Claims will deny for providers who fail to revalidate by the due date, and their Medicaid billing privileges will be deactivated. If this happens, providers must resubmit a complete enrollment application to reactivate their billing privileges. Medicaid will not reimburse providers for any services during the period of deactivation.

There are no exemptions from revalidation. Louisiana Medicaid does not grant extensions; the notification email and letter will allow sufficient time to revalidate before your due date.