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A BILL TO BE ENTITLED
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AN ACT
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relating to Medicaid provider enrollment revalidation. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter D, Chapter 532, Government Code, as |
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effective April 1, 2025, is amended by adding Section 532.01511 to |
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read as follows: |
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Sec. 532.01511. REVALIDATION OF PROVIDER ENROLLMENT. (a) |
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At least 120 days before the date a Medicaid provider's Medicaid |
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enrollment period expires, the commission shall provide to the |
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provider written notice of the upcoming expiration. The notice must |
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include: |
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(1) the date on which the provider's enrollment will |
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expire; and |
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(2) information on the process for revalidating the |
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provider's enrollment, including: |
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(A) the form and manner for applying for |
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revalidation; |
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(B) the information and documentation the |
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provider must submit with an application for revalidation of |
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enrollment; and |
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(C) a suggested timeline for submitting the |
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application, including the required information and documentation, |
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to ensure timely reenrollment and avoid disenrollment for failure |
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to revalidate enrollment before the provider's enrollment period |
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expires. |
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(b) If a Medicaid provider submits an application for |
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revalidation of enrollment at least 90 days before the date a |
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Medicaid provider's Medicaid enrollment period expires, the |
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commission shall review the application to determine whether the |
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application contains any obvious deficiencies. If the commission |
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identifies a deficiency, the commission shall: |
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(1) notify the provider of the deficiency at least 60 |
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days before the date the provider's enrollment period expires; |
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(2) provide the provider at least 10 days to correct |
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the deficiency; and |
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(3) if the provider corrects the deficiency within the |
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time provided under Subdivision (2), review the corrected |
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application in a timely manner to allow for any additional |
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deficiency to be determined and addressed before the date the |
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provider's enrollment period expires. |
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(c) If a Medicaid provider in good faith submits an |
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application for revalidation and complies with all specified |
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deadlines for corrections, the commission must finalize the |
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application before the provider's enrollment period expires, |
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regardless of the number of required corrections. |
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SECTION 2. Section 532.01511, Government Code, as added by |
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this Act, applies only to a Medicaid provider whose enrollment |
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period expires on or after January 1, 2026. |
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SECTION 3. If before implementing any provision of this Act |
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a state agency determines that a waiver or authorization from a |
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federal agency is necessary for implementation of that provision, |
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the agency affected by the provision shall request the waiver or |
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authorization and may delay implementing that provision until the |
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waiver or authorization is granted. |
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SECTION 4. This Act takes effect September 1, 2025. |