Texas 2025 - 89th Regular

Texas Senate Bill SB2348 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	89R4910 AND-D
2	2	By: Alvarado S.B. No. 2348
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7	7	A BILL TO BE ENTITLED
8	8	AN ACT
9	9	relating to Medicare provider certification and enrollment
10	10	prerequisites to Medicaid and child health plan program provider
11	11	enrollment.
12	12	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
13	13	SECTION 1. Subchapter D, Chapter 532, Government Code, as
14	14	effective April 1, 2025, is amended by adding Section 532.0159 to
15	15	read as follows:
16	16	Sec. 532.0159. MEDICARE PROVIDER CERTIFICATION OR
17	17	ENROLLMENT AS PREREQUISITE TO MEDICAID PROVIDER ENROLLMENT. (a)
18	18	This section applies only to a provider that has not been terminated
19	19	or excluded from participating as a provider under Medicare,
20	20	another state's Medicaid program, or the child health plan program.
21	21	(b) To participate as a provider in Medicaid, a provider
22	22	must be certified for enrollment or enrolled as a provider in
23	23	Medicare unless the provider is exempted as provided by Subsection
24	24	(c).
25	25	(c) A provider is exempt from the Medicare certification or
26	26	enrollment requirement under Subsection (b) if:
27	27	(1) the provider's type of practice or health care
28	28	services offered are not covered by Medicare;
29	29	(2) the provider's exclusion from Medicaid
30	30	participation on the basis of the lack of Medicare certification or
31	31	enrollment will restrict a recipient's access to necessary
32	32	services; or
33	33	(3) a commission or other state agency rule expressly
34	34	exempts the provider from the Medicare certification or enrollment
35	35	requirement.
36	36	SECTION 2. Subchapter D, Chapter 62, Health and Safety
37	37	Code, is amended by adding Section 62.1562 to read as follows:
38	38	Sec. 62.1562. MEDICARE PROVIDER CERTIFICATION OR
39	39	ENROLLMENT AS PREREQUISITE TO CHILD HEALTH PLAN PROGRAM HEALTH CARE
40	40	PROVIDER ENROLLMENT. (a) This section applies only to a health
41	41	care provider that has not been terminated or excluded from
42	42	participating as a provider under Medicare or this state's or
43	43	another state's Medicaid program.
44	44	(b) To participate as a health care provider in the child
45	45	health plan program, a health care provider must be certified for
46	46	enrollment or enrolled as a provider in Medicare unless the
47	47	provider is exempted as provided by Subsection (c).
48	48	(c) A health care provider is exempt from the Medicare
49	49	provider certification or enrollment requirement under Subsection
50	50	(b) if:
51	51	(1) the provider's type of practice or health care
52	52	services offered are not covered by Medicare;
53	53	(2) the provider's exclusion from child health plan
54	54	program participation on the basis of the lack of Medicare
55	55	certification or enrollment will restrict an enrollee's access to
56	56	necessary health care services; or
57	57	(3) a commission or other state agency rule expressly
58	58	exempts the provider from the Medicare certification or enrollment
59	59	requirement.
60	60	SECTION 3. If before implementing any provision of this Act
61	61	a state agency determines that a waiver or authorization from a
62	62	federal agency is necessary for implementation of that provision,
63	63	the agency affected by the provision shall request the waiver or
64	64	authorization and may delay implementing that provision until the
65	65	waiver or authorization is granted.
66	66	SECTION 4. This Act takes effect September 1, 2025.