NAMPI Member Portal | Dale Carr | Activity https://member.nampi.net/members/dale-carrdss-mo-gov/activity/ Activity feed for Dale Carr. Wed, 29 Apr 2026 17:22:00 -0400 https://buddypress.org/?v=2.14.4 en-US 30 hourly 2 5997a93fbe9d24e2a71b53019acee9d3 Dale Carr replied to the discussion MOU with MFCU in the forum State Only Forum https://member.nampi.net/nampi-member-forums/discussion/mou-with-mfcu/#post-2357 Wed, 17 Apr 2024 18:45:50 -0400 Reply to MOU with MFCU

Jennifer .. I will send Missouri’s to you .. please email me at Dale.Carr@dss.mo.gov and I will respond with the MOU.

Dale Carr, Director, Missouri Medicaid Audit & Compliance

]]> b3dd7a52a4488928e0296e589895f0db Dale Carr replied to the discussion Administrative terminations for criminal acts not involving Medicaid in the forum State Only Forum https://member.nampi.net/nampi-member-forums/discussion/administrative-terminations-for-criminal-acts-not-involving-medicaid/#post-2283 Mon, 25 Dec 2023 22:37:26 -0500 Reply to Administrative terminations for criminal acts not involving Medicaid

Kurt .. I have provided a link to our Missouri Medicaid provider sanctions regulation. It is somewhat broader than your state’s rules:

Missouri Secretary of State: Code of State Regulations

mo.gov)https://www.sos.mo.gov/cmsimages/adrules/csr/current/13csr/13c70-3.pdf

Look specifically at 13 CSR 70-3.030(3)(A)(32)

Best regards .. Dale Carr

]]> 8d2b1532b105ad3f0013e4d792ee7dd0 Dale Carr replied to the discussion Self Disclosures in the forum State Only Forum https://member.nampi.net/nampi-member-forums/discussion/self-disclosures/#post-2105 Thu, 08 Jun 2023 13:47:11 -0400 Reply to Self Disclosures

Good morning .. Missouri does not post self-disclosures on our website.

Dale Carr

]]> ed5bc75219f5f23f8f0fab80351944c7 Dale Carr started the discussion UPIC Session at NAMPI Annual Conference in the forum State Only Forum https://member.nampi.net/nampi-member-forums/discussion/upic-session-at-nampi-annual-conference/ Sun, 04 Jun 2023 23:53:35 -0400 UPIC Session at NAMPI Annual Conference

Fellow NAMPI Members,

The 2023 NAMPI Annual Conference in Scottsdale, AZ, is just a few weeks away and we hope you are planning to attend. One of the many great presentations will be a panel discussion on how the state Medicaid PI units can work with the Unified Program Integrity Contractors (UPICs). We have a great panel including Sherri…

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]]> 3fea3e2bbbcc6182735e969445346e1c Dale Carr posted an update: Fellow NAMPI Members,The 2023 NAMPI Annual Conference […] https://member.nampi.net/news-feed/p/2275/ Sun, 04 Jun 2023 23:48:58 -0400 Fellow NAMPI Members,

The 2023 NAMPI Annual Conference in Scottsdale, AZ, is just a few weeks away and we hope you are planning to attend. One of the many great presentations will be panel discussion on how the state Medicaid PI units can work with the Unified Program Integrity Contractors (UPICs). We have a great panel including Sherri…

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]]> 0 a711956e9d9493667e8cea86ba1f77c6 Dale Carr replied to the discussion Payment Suspension against 1 provider in group practice in the forum State Only Forum https://member.nampi.net/nampi-member-forums/discussion/payment-suspension-against-1-provider-in-group-practice/#post-1907 Wed, 15 Feb 2023 01:55:53 -0500 Reply to Payment Suspension against 1 provider in group practice

In Missouri, we would send a full payment suspension letter to the individual practitioner and a partial payment suspension letter to the group practice for any claims where that individual practitioner was the performing/rendering provider.

]]> b7da7fd26dfd38fbea79fd0042d5787c Dale Carr replied to the discussion UPIC Final Findings Report (FFR) in the forum State Only Forum https://member.nampi.net/nampi-member-forums/discussion/upic-final-findings-report-ffr/#post-1836 Thu, 29 Dec 2022 16:56:24 -0500 Reply to UPIC Final Findings Report (FFR)

Cindy – Your state should have had the opportunity to review and approve the UPIC’s Initial Findings Report (IFR) and any Revised Initial Findings Report (RIFR) after the provider being audited submitted a rebuttal to the IFR. We usually tell the UPIC after the IFR or RIFR if we are not comfortable with their findings or that we are not…

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]]> 65c3e58ec09a5972fa2488c5dee5bebd Dale Carr replied to the discussion CMS Directed Reviews of MCEs by the UPICs in the forum State Only Forum https://member.nampi.net/nampi-member-forums/discussion/cms-directed-reviews-of-mces-by-the-upics/#post-1767 Mon, 24 Oct 2022 02:51:41 -0400 Reply to CMS Directed Reviews of MCEs by the UPICs

Meant to say Medicare, Medicaid FFS and Medicaid MCO claims .. Dale

]]> 2a1a61728869e66459181f4a076b3ea4 Dale Carr replied to the discussion CMS Directed Reviews of MCEs by the UPICs in the forum State Only Forum https://member.nampi.net/nampi-member-forums/discussion/cms-directed-reviews-of-mces-by-the-upics/#post-1766 Mon, 24 Oct 2022 02:49:55 -0400 Reply to CMS Directed Reviews of MCEs by the UPICs

I agree with Kim. Our UPIC JOA specifies that we can approve or disapprove any audits. However, our UPIC did begin conducting audits of MCO DME claims about a year ago. It is the first time they have looked at MCO encounter claims and our first time helping them get records from the MCOs. As part of their project, the UPIC is looking at…

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