PLEASE DISREGARD HIGHMARK DISCLOSURE REQUEST

You recently received a letter from Highmark West Virginia (d.b.a. Highmark Blue Cross and Blue Shield of West Virginia and/or through its subsidiary Highmark West Virginia Family Health Plan, Inc.) requesting a Medicaid disclosure form for your practice.

PLEASE DISREGARD THE HIGHMARK DISCLOSURE REQUEST.

After clarification with the state, it has been determined that Molina will be obtaining and maintaining a Medicaid disclosure for all individual practitioners who provide services to WV Medicaid enrollees which will be accessible to the Managed Care Organizations eliminating the need for us to gather updated disclosure forms at this time. Additionally, within the past month, you may have received a notice from DHHR related to updated filings required for providers who would like to provide services to Medicaid members as part of the state's revalidation project. It is very important you respond to the DHHR/Molina request if you received a notice from them to meet the state's reporting requirements. For more information on that application and request, you can visit Molina's Provider Enrollment web page at www.wvmmis.com and click on the Provider Enrollment link. Please accept our apology for the confusion our July 7th notice created. We appreciate your service to our members, and look forward to working with you.