Every state runs its own clock. You need one board.
A group operating in six states is not managing one enrollment. It is managing six portals, six revalidation cycles, and one federal ownership-disclosure standard that every one of them enforces differently.
The short answer: Medicare revalidates enrollment at least every five years under 42 CFR 424.515, and state Medicaid programs revalidate at least every five years under 42 CFR 455.414. The clocks do not align, the portals do not talk, and a single missed revalidation deactivates billing in that state. Credential OS puts all of them on one geo-grid so nothing lapses silently.
The Map / State Portal Grid
One provider, one national footprint, ten different front doors
Federal enrollment lives in PECOS. Medicaid enrollment lives in each state's own portal, on each state's own revalidation calendar. Here is what a multi-state group is actually tracking. Cycle length reflects the federal five-year ceiling under 42 CFR 455.414; the meter shows illustrative time-elapsed against that ceiling, not a real client schedule.
The Revalidation Clock
Why a five-year cycle still needs a monthly watch
Revalidation is not a single date. Each state sends notices on its own lead time, holds its own document window, and deactivates on its own deadline. Miss the window and re-enrollment, not renewal, is what you file next.
Lead times shown are the shape of the process, not a fixed federal schedule. States set their own notice windows, which is exactly why a group cannot track this from a spreadsheet of due dates alone. The window, not the date, is what you manage.
42 CFR Part 455, Subpart B
The disclosure standard is federal. The enforcement is per state.
Ownership and control disclosure is the requirement most likely to stall a multi-state group, because it changes every time the group's cap table changes and it must be current in every state at once.
Ownership and control interest
Disclose every person or entity with a 5% or greater ownership or controlling interest, plus managing employees and agents.
- Names, addresses, dates of birth, and SSN or EIN
- Relationships among owners of the disclosing entity
- Refreshed at enrollment, revalidation, and on request
Transactions and convictions
Disclose business transactions with subcontractors on request, and any managing employee or owner convicted of a program-related crime.
- Subcontractor transactions within the prior 12 months
- Criminal conviction history for owners and agents
- A conviction can bar or terminate enrollment
Screening and database checks
Providers screen at limited, moderate, or high risk by type. States verify against federal exclusion and licensure databases at each cycle.
- Risk tier drives fingerprinting and site-visit rules
- Checks against the OIG LEIE and SAM exclusion lists
- 21st Century Cures Act 5005 requires ordering and referring provider enrollment
Federal vs State, Side by Side
What PECOS covers, and what it does not
PECOS is the system of record for Medicare, and it feeds ordering and referring status nationally. It is not your Medicaid enrollment. This is the gap a payer enrollment platform has to close.
| Dimension | PECOS (Medicare) | State Medicaid Portal |
|---|---|---|
| Authority | CMS, 42 CFR 424 Subpart P | State agency, 42 CFR 455 Subpart E |
| Enrollment form | CMS-855A/B/I/R | State application (PAVE, TMHP, NCTracks, and others) |
| Revalidation interval | At least every 5 years (424.515); DMEPOS every 3 (424.57) | At least every 5 years (455.414), state may be shorter |
| Ownership disclosure | 855 disclosure sections | 42 CFR 455.104 to 455.106, per state form |
| Application fee | Indexed annual fee (424.514) | Indexed annual fee (455.460), often accepted from Medicare |
| Deactivation risk | Loss of Medicare billing privileges | Loss of billing in that one state only |
Why this matters operationally: a group can be perfectly current in PECOS and still lose Medicaid billing in three states because nobody was watching those three portals. The systems do not reconcile themselves. The application fee amount referenced above is set by CMS each year through a Federal Register notice and is not restated here to avoid quoting a stale figure.
How Credential OS Runs It
From scattered portals to one revalidation board
Credential OS is the payer enrollment platform inside our credentialing stack. It treats every PECOS record and every state Medicaid enrollment as one tracked entity on a shared clock.
Register
Every provider, every state, every payer ID mapped to one profile
Clock
Each state's cycle and notice window tracked against 42 CFR 455.414
Disclose
One current 455.104 ownership record pushed to every state form
Alert
Lead-time warnings before the window opens, not after it closes
Prove
Audit trail of every submission, fee, and screening result by state
Stop tracking twelve portals in a spreadsheet nobody trusts
If your group bills Medicaid in more than one state, a single silent deactivation can cost more than a quarter of revenue in that market. Credential OS keeps PECOS and every state Medicaid cycle on one board, with the ownership-disclosure record current everywhere at once. Let us show you your own footprint on the map.
Map my enrollment footprint → Talk to a credentialing leadSources referenced: CMS Provider Enrollment, Chain and Ownership System (PECOS); 42 CFR 424 Subpart P (Medicare enrollment and 424.515 revalidation; 424.57 DMEPOS; 424.514 fee); 42 CFR 455 Subpart B (455.104, 455.105, 455.106 ownership and disclosure) and Subpart E (455.414 revalidation, 455.436 database checks, 455.450 screening levels, 455.460 application fee); 21st Century Cures Act Section 5005. State portals named as examples: California PAVE, Texas TMHP, New York eMedNY, Pennsylvania PROMISe, Florida FMMIS, Ohio PNM, Georgia GAMMIS, Illinois IMPACT, North Carolina NCTracks, Washington ProviderOne, Michigan CHAMPS. Cycle meters are illustrative and do not represent a specific provider or client schedule.
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