News

Immediate Action Required for TX Medicaid Re-enrollment

Date: 08/31/16

This article has been update. Please visit, HHSC NOTICE: Provider Re-enrollment Deadline Extension to view the most current information.

Texas Medicaid must comply with federal regulations, which requires all providers to re-enroll in the Medicaid program every three to five years. Any Medicaid provider enrolled before January 1, 2013, must be fully re-enrolled by March 24, 2016.

To be considered fully re-enrolled, providers must:

  • Submit a completed re-enrollment application and;
  • Receive notification from Texas Medicaid and Healthcare Partnership (TMHP) that their application has been approved.

Application processing times will vary based on accuracy and complexity of the application. To allow sufficient time for re-enrollment application processing, providers are encouraged to begin this process immediately.

Providers who are not fully re-enrolled by March 24, 2016 will have to complete a new enrollment application to return to the program and may experience:

  • Interruption in reimbursement for Medicaid services provided in fee-for-service and managed care.
  • Denial of claims for Medicaid services indicating that the provider is not actively enrolled.
  • Removal from or difficulties with networks, specifically managed care organization (MCO) or dental maintenance organization (DMO) networks. Providers must be enrolled in Texas Medicaid before they can be contracted and credentialed by an MCO or DMO. Providers must be re-enrolled to maintain credentialing with their plans.

For questions, or to re-enroll, visit www.TMHP.com or contact:

TMHP Contact Center: 1-800-925-9126
Superior’s Provider Services: 1-877-391-5921