89R15296 LRM-D
By: Guerra H.B. No. 4845
A BILL TO BE ENTITLED
AN ACT
relating to Medicaid provider enrollment revalidation.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter D, Chapter 532, Government Code, as
effective April 1, 2025, is amended by adding Section 532.01511 to
read as follows:
Sec. 532.01511. REVALIDATION OF PROVIDER ENROLLMENT. (a)
At least 120 days before the date a Medicaid provider's Medicaid
enrollment period expires, the commission shall provide to the
provider written notice of the upcoming expiration. The notice must
include:
(1) the date on which the provider's enrollment will
expire; and
(2) information on the process for revalidating the
provider's enrollment, including:
(A) the form and manner for applying for
revalidation;
(B) the information and documentation the
provider must submit with an application for revalidation of
enrollment; and
(C) a suggested timeline for submitting the
application, including the required information and documentation,
to ensure timely reenrollment and avoid disenrollment for failure
to revalidate enrollment before the provider's enrollment period
expires.
(b) If a Medicaid provider submits an application for
revalidation of enrollment at least 90 days before the date a
Medicaid provider's Medicaid enrollment period expires, the
commission shall review the application to determine whether the
application contains any obvious deficiencies. If the commission
identifies a deficiency, the commission shall:
(1) notify the provider of the deficiency at least 60
days before the date the provider's enrollment period expires;
(2) provide the provider at least 10 days to correct
the deficiency; and
(3) if the provider corrects the deficiency within the
time provided under Subdivision (2), review the corrected
application in a timely manner to allow for any additional
deficiency to be determined and addressed before the date the
provider's enrollment period expires.
(c) If a Medicaid provider in good faith submits an
application for revalidation and complies with all specified
deadlines for corrections, the commission must finalize the
application before the provider's enrollment period expires,
regardless of the number of required corrections.
SECTION 2. Section 532.01511, Government Code, as added by
this Act, applies only to a Medicaid provider whose enrollment
period expires on or after January 1, 2026.
SECTION 3. 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 4. This Act takes effect September 1, 2025.