By: Hull, et al. (Senate Sponsor - Cook, et al.) H.B. No. 3151
         (In the Senate - Received from the House May 14, 2025;
  May 14, 2025, read first time and referred to Committee on Health &
  Human Services; May 23, 2025, reported favorably by the following
  vote:  Yeas 9, Nays 0; May 23, 2025, sent to printer.)
Click here to see the committee vote
 
 
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.
 
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