89R4745 CMO-F
By: Alvarado S.B. No. 1266
A BILL TO BE ENTITLED
AN ACT
relating to Medicaid provider enrollment and credentialing
processes.
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 Sections 532.01511
and 532.01512 to read as follows:
Sec. 532.01511. PROVIDER ENROLLMENT AND CREDENTIALING
PROCESSES: PROVIDER SUPPORT; COMPLAINTS. (a) The commission shall
ensure that providers have access to a dedicated support team for
the Internet portal established under Section 532.0151 that:
(1) assists current and prospective Medicaid
providers in completing the Medicaid provider enrollment and
credentialing processes; and
(2) reduces the administrative burdens associated
with those processes.
(b) The commission shall:
(1) annually evaluate the performance of the support
team described by Subsection (a), including the timeliness of
assistance the support team provides; and
(2) not later than September 1 of each year, post on
the commission's Internet website a report summarizing the results
of the evaluation conducted under Subdivision (1).
(c) For purposes of improving the commission's Medicaid
provider enrollment and credentialing processes, the commission
shall develop a procedure by which a provider may electronically
submit complaints and feedback about those processes and the
support provided by the support team described by Subsection (a).
Information about the procedure must:
(1) be prominently posted on the commission's or the
commission's designee's Internet website in the same location that
instructions and resources for using the Internet portal
established under Section 532.0151 are posted; and
(2) allow a provider to submit a complaint or provide
feedback through an electronic form from that location.
Sec. 532.01512. NOTICE OF PROVIDER DISENROLLMENT. Before
the commission may disenroll a Medicaid provider during the
provider's enrollment revalidation period, the commission must:
(1) not later than 30 days before the date of
disenrollment provide electronically and by mail to the provider
written notice of the commission's disenrollment determination;
and
(2) allow the provider to address any deficiencies in
the provider's application for revalidation of enrollment before
the date the provider will be disenrolled.
SECTION 2. Notwithstanding Section 532.01511, Government
Code, as added by this Act, the Health and Human Services Commission
shall conduct the initial evaluation and post the report
summarizing the results of the evaluation as required by that
section not later than September 1, 2026.
SECTION 3. As soon as possible after the effective date of
this Act, the Health and Human Services Commission shall:
(1) ensure the Internet portal support team required
by Section 532.01511(a), Government Code, as added by this Act, is
established; and
(2) adopt rules necessary to implement the changes in
law made by this Act.
SECTION 4. 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 5. This Act takes effect September 1, 2025.