How to obtain a MOU

In order to obtain a MOU with the Region Five Hub, please contact: [email protected]

The following documents are needed:

• A current copy of Licensure
• A current copy of insurance
• VCC Provider Roster with staffing plan spreadsheet
  (supplied by the Hub)
• Copy of MOUs with any other Hub
• Copy of attestation of enrollment as a Medicaid Provider

MOU / MOU Renewal Dates

MOUs renew annually, and information pertaining to the renewal will come out prior to expiration of the previous MOU.

The period to enter into or renew your MOU with Region Five will begin annually on April 1st.