ODP Provider Requalification Process

ODP Announcement 21-007 provides written notification of the requirement to submit qualification documentation for providers who have a Master Provider Index (MPI) number ending in zero, one, or two. Providers within this group are due to become requalified in 2021 and must submit documentation no later than 61 days prior to the expiration of provider qualification.

Specifically, supporting documentation must be submitted starting on February 1, 2021 but no later than March 31, 2021. Documentation must include a completed DP 1059 form and/or DP 1088 form, an updated Provider Qualification Documentation Record, and any required supporting documentation. Please note that the updated Provider Qualification Documentation Record now has new tabs that pertain specifically to Adult Autism Waiver (AAW) providers.