DS1891 Information Required

Under current law and regulation all regional center providers of client services must complete a DS1891 Medicaid Integrity form.  Alta utilizes a service bureau that will allow each vendor to go on-line to enter the required information.  This electronic method will simplify the process and allow each provider to complete this process on-line.  

In order to begin using this process each service provider for each vendor number must designate one person as the contact. Alta needs to know the contact person and their email address and phone number. Vendor numbers will be linked together in the online portal account based on EIN or SSN. A single contact person can then manage multiple DS1891 forms in the portal account. You will need to complete a separate survey for each vendor number. 

In order to complete the survey click on the link below and enter the requested information for each vendor number.  Thank you for your assistance.