Revalidation
Puerto Rico Medicaid Management Information System (PRMMIS)
What is the Purpose of Revalidation?
- To ensure that provider information is accurate and that active providers are still eligible to participate in the Puerto Rico Medicaid Program (PRMP)
- Active providers are required to complete revalidation within the specific timeframe established by the Puerto Rico Medicaid Program.
- Ensures that the Puerto Rico Medicaid Program (PRMP) complies with federal regulations (42 CFR § 455.414).
- Ensures that Puerto Rico beneficiaries continue to receive quality care.
- Provides continuity in mitigating the risk of fraud.
When must a provider revalidate?
- Any active provider who has received the 90-day revalidation reminder letter must revalidate.
- The revalidation notification is obtained in the messages section of the Provider Secure Communication (PSC).
- Providers will also receive a Revalidation reminder notification to their “Mail-to” email referring the provider to their PSC account.
- The providers will receive the first revalidation reminder 90 days prior to the termination date of their Medicaid agreement.
- The Medicaid Program requires all physicians to revalidate their information every 5 years.
- Non-physician providers with an effective date before 12/31/2022 must revalidate 4 years from their Medicaid Agreement effective date.
- Non-physician providers with an effective date of 1/1/2023 or later must revalidate their information within 3 years from their Medicaid Agreement effective date.
Note: The frequency of revalidation is subject to the terms in section 2.7 of the Provider Agreement.
How does the combined revalidation process work for providers with multiple service locations?
Eligible providers who have multiple service locations enrolled in PRMP will first receive a notification informing them of the option to complete a combined revalidation (see notification schedule below). The notification will instruct providers to log into PSC and select their desired service locations for their combined revalidation. Based on the provider’s service location selections in PSC, the system will generate a combined revalidation application that will become available in PEP 90 days prior to the agreement end date of the lowest Medicaid ID within the combined group. The provider will have 90 days to complete and submit the combined revalidation application. Once the revalidation application is approved, the system will apply updates to all selected service locations under the combined revalidation group. For more information on global changes, click here.
How does the combined revalidation process work, and what are the key dates and criteria?
Beginning in 2025, PSC allows eligible providers to revalidate multiple service locations in a single application. Providers qualify if they share the same NPI, Provider Type, Enrollment Type, and can submit multiple locations during their PEP enrollment. Eligible locations must have Medicaid Agreement End Dates within 130–365 days of the current date.
Notification Schedule for 2025:
- Second Notification: Sent 30 days after the initial letter if no action is taken.
- Third (Final) Notification: Sent another 30 days after the second reminder.
After receiving the Combined Revalidation First Notification providers should log into the PSC to review and select locations for combined revalidation. Once logged into PSC, the providers will choose the "Lowest MEDICAID ID" for their grouped Service Locations, and the revalidation approval will apply updates across all selected locations. For detailed instructions and an example letter, click here.
What happens if my revalidation application is still being reviewed by PRMP after my Medicaid agreement ends?
If your revalidation application is still under review after your Medicaid agreement expires, your services will be placed on a restricted status. During this time, any claims or encounters you submit will be temporarily suspended. Once your revalidation application is finalized, those claims or encounters will be processed as appropriate.
What happens if my revalidation application is returned for missing information while I am on restricted service?
If your revalidation application is returned to you for missing or incorrect information while you are on restricted service, you have 14 days to correct and resubmit it. If you don’t return the corrected application within 14 days, your revalidation will fail, and you’ll need to submit a new enrollment application prior to your agreement end date.
Communication Plan/Letters
- All the Communications sent to the providers related to the Revalidation process will be sent to the email registered as “mail to” and to the Providers Secure Communication.
- The letters that providers will be receiving are:
- Provider Revalidation Reminder Letter 90 days
- Provider Revalidation Reminder Letter 60 days
- Provider Revalidation Reminder Letter Final
- To view all communication sent to providers regarding Revalidation click here.
Federal & State Regulations
Provider screening includes, but not limited to:
- Facility Licensure (SARAFS)
- Individual Licensure (ORCPS)
- Controlled Substance Certificate
- Local Police Screening (Penal Record)
- Fingerprint Social Security Death Master File
- Background Check (PRBCP)
- EPLS/SAM (Excluded)
- LEIE (OIG)
- PECOS (Medicare
- NPPES (NPI Data)
- DEA (Narcotics)
- CLIA (Laboratories)
Revalidation Training Resources
- Providers will have multiple options for revalidation training including:
- Live Training Sessions conducted via Microsoft Teams (See Training Schedule below)
- Pre-recorded Training Sessions
- Self-Paced videos for convenience
- Reference and Navigational Guides in LMS
Live Training Schedule
- Training sessions will last approximately 2 hours (depending upon volume of provider questions)
| Date |
Time |
Enrollment type |
Registration Link |
| February 4, 2025 |
10:00 AM AST |
Individuals within a Group Revalidation |
https://events.teams.microsoft.com/event/c87c68fe-0775-46f7-a9dd-43a43baf2e03@a621df4e-38c9-432d-a2d6-178cc8ca9e0b |
| February 6, 2025 |
1:00 PM AST |
Facilities Revalidation |
https://events.teams.microsoft.com/event/a539d85b-9dfb-4b35-9615-19afe8f96c57@a621df4e-38c9-432d-a2d6-178cc8ca9e0b |
| February 11, 2025 |
10:00 AM AST |
Individual Revalidation |
https://events.teams.microsoft.com/event/fc027fb3-146b-46b4-ac0b-0236a0a4aebc@a621df4e-38c9-432d-a2d6-178cc8ca9e0b |
| February 13,2025 |
1:00 PM AST |
Group Revalidation |
https://events.teams.microsoft.com/event/5b542b91-e54c-4a3f-8457-dc58ebb3623d@a621df4e-38c9-432d-a2d6-178cc8ca9e0b |
| February 18,2025 |
10:00 AM AST |
Facilities Revalidation |
https://events.teams.microsoft.com/event/18c1dbbf-d537-4996-aa57-75b88a96f823@a621df4e-38c9-432d-a2d6-178cc8ca9e0b |
February 20,2025 |
1:00 PM AST |
Individuals within a Group Revalidation |
https://events.teams.microsoft.com/event/1a510d99-6d2f-47a8-b6e6-e9c08286431c@a621df4e-38c9-432d-a2d6-178cc8ca9e0b |
February 25,2025 |
10:00 AM AST |
Individuals within a Group Revalidation/td>
| https://events.teams.microsoft.com/event/8c9a5895-6321-4ba4-ae5f-570dada6c2e3@a621df4e-38c9-432d-a2d6-178cc8ca9e0b |
February 27,2025 |
1:00 PM AST |
Facilities Revalidation |
https://events.teams.microsoft.com/event/8144e51a-7e64-4910-8e7b-42c86cf0007d@a621df4e-38c9-432d-a2d6-178cc8ca9e0b |
March 4, 2025 |
10:00 AM AST |
Facilities Revalidation |
https://events.teams.microsoft.com/event/8bb8b9f9-ab08-46f5-ba8a-c0aa39e8a627@a621df4e-38c9-432d-a2d6-178cc8ca9e0b |
March 6, 2025 |
1:00 PM AST |
Individuals within a Group Revalidation |
https://events.teams.microsoft.com/event/8cab8bc4-8e45-478c-8633-88a3f89a7257@a621df4e-38c9-432d-a2d6-178cc8ca9e0b |
March 11, 2025 |
10:00 AM AST |
Individuals within a Group Revalidation |
https://events.teams.microsoft.com/event/d6ba68f8-4cb9-47d8-b340-04904913a6c3@a621df4e-38c9-432d-a2d6-178cc8ca9e0b |
March 13, 2025 |
1:00 PM AST |
Group Revalidation |
https://events.teams.microsoft.com/event/4863eece-2de0-4b3f-bacf-059841651c1f@a621df4e-38c9-432d-a2d6-178cc8ca9e0b |
March 18, 2025 |
10:00 AM AST |
Facilities Revalidation |
https://events.teams.microsoft.com/event/d3a84bc5-7457-4999-9549-fe7f0540441a@a621df4e-38c9-432d-a2d6-178cc8ca9e0b |
March 20, 2025 |
1:00 PM AST |
Individuos dentro de un Grupo de Revalidación |
https://events.teams.microsoft.com/event/6cae1162-8582-4098-8898-08adba4a7871@a621df4e-38c9-432d-a2d6-178cc8ca9e0b |
March 25, 2025 |
10:00 AM AST |
Individual Revalidation |
https://events.teams.microsoft.com/event/d5530078-5678-4772-a484-b86f819b136b@a621df4e-38c9-432d-a2d6-178cc8ca9e0b |
March 27, 2025 |
1:00 PM AST |
Individual Revalidation |
https://events.teams.microsoft.com/event/d7077441-25ea-4853-a88a-6ed6032eafb0@a621df4e-38c9-432d-a2d6-178cc8ca9e0b |
April 1, 2025 |
10:00 AM AST |
Facilities Revalidation |
https://events.teams.microsoft.com/event/8f0f5338-d5ba-4e3d-b86a-a5d53df1ae21@a621df4e-38c9-432d-a2d6-178cc8ca9e0b |
April 3, 2025 |
1:00 PM AST |
Individuos dentro de un Grupo de Revalidación |
https://events.teams.microsoft.com/event/e83b1ee8-5ab8-40b0-a7c0-71363a94805a@a621df4e-38c9-432d-a2d6-178cc8ca9e0b |
April 8, 2025 |
10:00 AM AST |
Individual Revalidation |
https://events.teams.microsoft.com/event/1046edaf-de06-4a8b-8b28-b15128ad4f7e@a621df4e-38c9-432d-a2d6-178cc8ca9e0b |
April 10, 2025 |
1:00 PM AST |
Group Revalidation |
https://events.teams.microsoft.com/event/84bde849-bc35-410a-a313-00959bde673d@a621df4e-38c9-432d-a2d6-178cc8ca9e0b |
April 15, 2025 |
10:00 AM AST |
Group Revalidation |
https://events.teams.microsoft.com/event/3704a830-3128-4b8a-8c18-1d1720fb9cb4@a621df4e-38c9-432d-a2d6-178cc8ca9e0b |
April 17, 2025 |
1:00 PM AST |
Individuos dentro de un Grupo de Revalidación |
https://events.teams.microsoft.com/event/e0cb028d-47b1-4825-928b-aded7e305be9@a621df4e-38c9-432d-a2d6-178cc8ca9e0b |
April 22, 2025 |
10:00 AM AST |
Individual Revalidation |
https://events.teams.microsoft.com/event/3c278139-06dd-42ac-9f4e-fb75522941fd@a621df4e-38c9-432d-a2d6-178cc8ca9e0b |
April 24, 2025 |
1:00 PM AST |
Facilities Revalidation |
https://events.teams.microsoft.com/event/2e5bebe6-e642-478f-827c-2c4922a7c4e0@a621df4e-38c9-432d-a2d6-178cc8ca9e0b |
April 29, 2025 |
10:00 AM AST |
Group Revalidation |
https://events.teams.microsoft.com/event/66bd82cf-07ab-425c-9b7a-8db316a4b023@a621df4e-38c9-432d-a2d6-178cc8ca9e0b |
Recorded Training Sessions
- Recorded training sessions are available for providers who are unable to attend live sessions or prefer a self-paced option. View sessions here.
Guides
- For additional information on how to navigate and references guides on PEP or PSC, please access the Learning Management System by clicking here.
Policies
- To access current policies regarding Revalidation please click here.
FAQ's
- To find answers to commonly asked questions, please view our FAQ’s page.