By: Hull, et al. H.B. No. 3151

A BILL TO BE ENTITLED

AN ACT

relating to expedited credentialing of certain federally qualified health center providers by Medicaid managed care organizations.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Sections 540.0656(a) and (d), Government Code, are amended to read as follows:

(a) In this section, "applicant provider" means a physician or other health care provider, including a federally qualified health center as defined by 42 U.S.C. Section 1396d(l)(2)(B) or a health care provider for the federally qualified health center, applying for expedited credentialing.

(d) To qualify for expedited credentialing and payment under Subsection (e), an applicant provider must:

(1) have a current contract with a Medicaid managed care organization or be a member of or a health care provider for one of the following that has a current contract with a Medicaid managed care organization:

(A) an established health care provider group; or

(B) a federally qualified health center as defined by 42 U.S.C. Section 1396d(l)(2)(B) [an established health care provider group that has a current contract with a Medicaid managed care organization];

(2) be a Medicaid-enrolled provider;

(3) agree to comply with the terms of the contract described by Subdivision (1); and

(4) submit all documentation and other information the Medicaid managed care organization requires as necessary to enable the organization to begin the credentialing process the organization requires to include a provider in the organization's provider network.

SECTION 2. If before implementing any provision of this Act a state agency determines that a waiver or authorization from a federal agency is necessary for implementation of that provision, the agency affected by the provision shall request the waiver or authorization and may delay implementing that provision until the waiver or authorization is granted.

SECTION 3. This Act takes effect September 1, 2025.