LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 89TH LEGISLATIVE REGULAR SESSION April 14, 2025 TO: Honorable Lois W. Kolkhorst, Chair, Senate Committee on Health & Human Services FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: SB1266 by Alvarado (Relating to Medicaid provider enrollment and credentialing processes.), As Introduced Estimated Two-year Net Impact to General Revenue Related Funds for SB1266, As Introduced: a negative impact of ($2,151,957) through the biennium ending August 31, 2027. General Revenue-Related Funds, Five- Year Impact: Fiscal Year Probable Net Positive/(Negative) Impact toGeneral Revenue Related Funds2026($1,020,868)2027($1,131,089)2028($1,131,419)2029($1,131,693)2030($922,063)All Funds, Five-Year Impact: Fiscal Year Probable Savings/(Cost) fromGR Match For Medicaid758 Probable Savings/(Cost) fromFederal Funds555 Change in Number of State Employees from FY 20252026($1,020,868)($1,004,434)2.02027($1,131,089)($1,273,512)2.02028($1,131,419)($1,273,622)2.02029($1,131,693)($1,273,714)2.02030($922,063)($1,203,837)2.0 Fiscal AnalysisThe bill would require the Health and Human Services Commission (HHSC) to ensure that Medicaid providers have access to a support team for the Internet portal through which providers may enroll in Medicaid.The bill would require HHSC to annually evaluate the performance of the support team, post the results of the evaluation on its website, and develop a procedure for Medicaid providers to submit complaints and feedback about enrollment and credentialing processes and support.The bill would establish notification and process requirements that HHSC must meet before disenrolling a Medicaid provider.The bill would take effect September 1, 2025.
LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 89TH LEGISLATIVE REGULAR SESSION
April 14, 2025
TO: Honorable Lois W. Kolkhorst, Chair, Senate Committee on Health & Human Services FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: SB1266 by Alvarado (Relating to Medicaid provider enrollment and credentialing processes.), As Introduced
TO: Honorable Lois W. Kolkhorst, Chair, Senate Committee on Health & Human Services
FROM: Jerry McGinty, Director, Legislative Budget Board
IN RE: SB1266 by Alvarado (Relating to Medicaid provider enrollment and credentialing processes.), As Introduced
Honorable Lois W. Kolkhorst, Chair, Senate Committee on Health & Human Services
Honorable Lois W. Kolkhorst, Chair, Senate Committee on Health & Human Services
Jerry McGinty, Director, Legislative Budget Board
Jerry McGinty, Director, Legislative Budget Board
SB1266 by Alvarado (Relating to Medicaid provider enrollment and credentialing processes.), As Introduced
SB1266 by Alvarado (Relating to Medicaid provider enrollment and credentialing processes.), As Introduced
Estimated Two-year Net Impact to General Revenue Related Funds for SB1266, As Introduced: a negative impact of ($2,151,957) through the biennium ending August 31, 2027.
Estimated Two-year Net Impact to General Revenue Related Funds for SB1266, As Introduced: a negative impact of ($2,151,957) through the biennium ending August 31, 2027.
General Revenue-Related Funds, Five- Year Impact:
2026 ($1,020,868)
2027 ($1,131,089)
2028 ($1,131,419)
2029 ($1,131,693)
2030 ($922,063)
All Funds, Five-Year Impact:
2026 ($1,020,868) ($1,004,434) 2.0
2027 ($1,131,089) ($1,273,512) 2.0
2028 ($1,131,419) ($1,273,622) 2.0
2029 ($1,131,693) ($1,273,714) 2.0
2030 ($922,063) ($1,203,837) 2.0
Fiscal Analysis
The bill would require the Health and Human Services Commission (HHSC) to ensure that Medicaid providers have access to a support team for the Internet portal through which providers may enroll in Medicaid.The bill would require HHSC to annually evaluate the performance of the support team, post the results of the evaluation on its website, and develop a procedure for Medicaid providers to submit complaints and feedback about enrollment and credentialing processes and support.The bill would establish notification and process requirements that HHSC must meet before disenrolling a Medicaid provider.The bill would take effect September 1, 2025.
The bill would require the Health and Human Services Commission (HHSC) to ensure that Medicaid providers have access to a support team for the Internet portal through which providers may enroll in Medicaid.
The bill would require HHSC to annually evaluate the performance of the support team, post the results of the evaluation on its website, and develop a procedure for Medicaid providers to submit complaints and feedback about enrollment and credentialing processes and support.
The bill would establish notification and process requirements that HHSC must meet before disenrolling a Medicaid provider.
The bill would take effect September 1, 2025.
Methodology
This analysis assumes that HHSC would require additional resources for Texas Medicaid and Healthcare Partnership (TMHP) contract needs, including funding for 14 additional vendor staff for the provider enrollment support team, postage costs related to new provider disenrollment requirements, and updates to policies, procedures, and resources. This additional need is estimated to total $1,562,352 from All Funds in each fiscal year.According to HHSC, 2.5 additional full-time equivalents (FTEs) would be needed to conduct activities required by the bill, including assistance with and resolution of provider complaints and escalations, monitoring and evaluation of the provider enrollment support team, and indirect support. This analysis assumes a total of 2.0 FTEs would be needed, including 1.0 Contract Specialist position and 1.0 Program Specialist position, in fiscal years 2026 through 2030. Personnel-related costs, including salaries, travel, and overhead are estimated to total $297,533 from All Funds in fiscal year 2026 and $278,701 from All Funds in fiscal year 2027.This analysis assumes that HHSC would require additional resources related to one-time modifications to the Provider Enrollment Management System (PEMS) and ongoing additional workload managed through PEMS. This additional need is estimated to total $165,417 from All Funds in fiscal year 2026 and $563,548 from All Funds in fiscal year 2027.
This analysis assumes that HHSC would require additional resources for Texas Medicaid and Healthcare Partnership (TMHP) contract needs, including funding for 14 additional vendor staff for the provider enrollment support team, postage costs related to new provider disenrollment requirements, and updates to policies, procedures, and resources. This additional need is estimated to total $1,562,352 from All Funds in each fiscal year.
According to HHSC, 2.5 additional full-time equivalents (FTEs) would be needed to conduct activities required by the bill, including assistance with and resolution of provider complaints and escalations, monitoring and evaluation of the provider enrollment support team, and indirect support. This analysis assumes a total of 2.0 FTEs would be needed, including 1.0 Contract Specialist position and 1.0 Program Specialist position, in fiscal years 2026 through 2030. Personnel-related costs, including salaries, travel, and overhead are estimated to total $297,533 from All Funds in fiscal year 2026 and $278,701 from All Funds in fiscal year 2027.
This analysis assumes that HHSC would require additional resources related to one-time modifications to the Provider Enrollment Management System (PEMS) and ongoing additional workload managed through PEMS. This additional need is estimated to total $165,417 from All Funds in fiscal year 2026 and $563,548 from All Funds in fiscal year 2027.
Technology
Included in the amounts above, the total non-FTE-related technology cost is estimated to be $165,417 from All Funds in fiscal year 2026 and $563,548 from All Funds in fiscal year 2027.
Local Government Impact
No significant fiscal implication to units of local government is anticipated.
Source Agencies: b > td > 529 Health and Human Services Commission
529 Health and Human Services Commission
LBB Staff: b > td > JMc, NPe, ER, ESch, NV
JMc, NPe, ER, ESch, NV