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A BILL TO BE ENTITLED
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AN ACT
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relating to Medicaid provider enrollment and credentialing |
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processes. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter D, Chapter 532, Government Code, as |
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effective April 1, 2025, is amended by adding Sections 532.01511 |
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and 532.01512 to read as follows: |
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Sec. 532.01511. PROVIDER ENROLLMENT AND CREDENTIALING |
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PROCESSES: PROVIDER SUPPORT; COMPLAINTS. (a) The commission shall |
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ensure that providers have access to a dedicated support team for |
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the Internet portal established under Section 532.0151 that: |
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(1) assists current and prospective Medicaid |
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providers in completing the Medicaid provider enrollment and |
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credentialing processes; and |
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(2) reduces the administrative burdens associated |
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with those processes. |
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(b) The commission shall: |
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(1) annually evaluate the performance of the support |
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team described by Subsection (a), including the timeliness of |
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assistance the support team provides; and |
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(2) not later than September 1 of each year, post on |
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the commission's Internet website a report summarizing the results |
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of the evaluation conducted under Subdivision (1). |
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(c) For purposes of improving the commission's Medicaid |
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provider enrollment and credentialing processes, the commission |
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shall develop a procedure by which a provider may electronically |
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submit complaints and feedback about those processes and the |
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support provided by the support team described by Subsection (a). |
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Information about the procedure must: |
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(1) be prominently posted on the commission's or the |
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commission's designee's Internet website in the same location that |
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instructions and resources for using the Internet portal |
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established under Section 532.0151 are posted; and |
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(2) allow a provider to submit a complaint or provide |
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feedback through an electronic form from that location. |
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Sec. 532.01512. NOTICE OF PROVIDER DISENROLLMENT. Before |
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the commission may disenroll a Medicaid provider during the |
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provider's enrollment revalidation period, the commission must: |
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(1) not later than 30 days before the date of |
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disenrollment provide electronically and by mail to the provider |
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written notice of the commission's disenrollment determination; |
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and |
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(2) allow the provider to address any deficiencies in |
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the provider's application for revalidation of enrollment before |
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the date the provider will be disenrolled. |
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SECTION 2. Notwithstanding Section 532.01511, Government |
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Code, as added by this Act, the Health and Human Services Commission |
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shall conduct the initial evaluation and post the report |
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summarizing the results of the evaluation as required by that |
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section not later than September 1, 2026. |
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SECTION 3. As soon as possible after the effective date of |
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this Act, the Health and Human Services Commission shall: |
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(1) ensure the Internet portal support team required |
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by Section 532.01511(a), Government Code, as added by this Act, is |
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established; and |
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(2) adopt rules necessary to implement the changes in |
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law made by this Act. |
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SECTION 4. If before implementing any provision of this Act |
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a state agency determines that a waiver or authorization from a |
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federal agency is necessary for implementation of that provision, |
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the agency affected by the provision shall request the waiver or |
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authorization and may delay implementing that provision until the |
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waiver or authorization is granted. |
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SECTION 5. This Act takes effect September 1, 2025. |