Texas Senate Bill SB2093

Texas 2025 - 89th Regular

• Filed: 3/7/25

Caption

Relating to expedited credentialing of certain federally qualified health center providers by managed care plan issuers and Medicaid managed care organizations.

Impact

If enacted, SB2093 will amend the Government Code and Insurance Code to facilitate faster access to Medicaid programs for providers associated with FQHCs. It requires that managed care plan issuers process applications and render decisions regarding credentialing within specified timeframes, promoting efficiency in provider onboarding. This could lead to a notable increase in the number of available healthcare services in underserved areas, thereby potentially enhancing public health outcomes across the state.

Summary

SB2093 aims to streamline the credentialing process for federally qualified health center (FQHC) providers by managed care plan issuers and Medicaid managed care organizations. The bill establishes an expedited credentialing process, allowing providers who meet specific criteria to be included as participating providers in managed care networks more rapidly. This initiative is intended to improve access to healthcare services by reducing the time necessary for health care providers to enroll in networks and begin serving patients.

Contention

There may be concerns regarding the balance between expedited credentialing and the safeguarding of healthcare standards. While the bill promotes quicker integration of FQHC providers into managed care, stakeholders might raise issues regarding the thoroughness of the credentialing processes. Critics could argue that rushing this process may compromise the quality of care or facilitate the entry of inadequately qualified providers into the system, though proponents emphasize the need for timely access to healthcare services.

Texas Constitutional Statutes Affected

Government Code

• Chapter 540. Medicaid Managed Care Program
  • Section: 0656

Insurance Code

• Chapter 1452. Physician And Provider Credentials
  • Section: New Section