Medicaid Providers Must Re-enroll

Updated January 19, 2016

***The Centers for Medicare and Medicaid Services (CMS) recently announced that the previous March 24, 2016 deadline for Medicaid provider re-enrollment is extended to September 25, 2016. Though this extension gives states additional time to ensure providers comply with Patient Protection and Affordable Care Act (PPACA) requirements, Texas Medicaid encourages all providers who have not yet submitted a re-enrollment application to begin this process immediately to avoid potential payment disruptions.***

As the result of a new federal regulation, all Texas Medicaid providers are now required to periodically revalidate their enrollment in the program. To comply with this mandate, any Texas 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 verification from TMHP that their application has been approved. The application takes about 30 minutes to complete. The average time to approve applications from time of application is 6-8 weeks; to allow sufficient time for re-enrollment application processing, providers are encouraged to begin this process as soon as possible. Each Medicaid Texas Provider Identifier (TPI)/practice location must re-enroll. 

This requirement applies to those providing services through any of the following:

  • Medicaid managed care organizations (MCOs)
  • Dental managed care organizations (DMOs)
  • Traditional fee-for-service Medicaid

To help simplify the re-enrollment process, the Texas Medicaid & Healthcare Partnership (TMHP) has recently introduced several new functionalities to their Provider Enrollment Portal.

  • Include pre-populated demographic data pulled from the provider's account information
  • Allow providers to sign the application agreements electronically (e-sign)
  • Allow providers to electronically upload supporting documentation
  • Add instructional text within the online provider enrollment application that provides information on how to submit an electronic signature and how to attach electronic documents.
  • Expand error messages to provide additional information
  • Allow higher web browser capability

For additional information, please visit the TMHP Provider Re-enrollment page and read the reminder notice from TMHP about re-enrolling. For help re-enrolling, contact a TMHP provider enrollment representative at 1-800-925-9126, Option 2, or attend one of the town hall meetings.

Check back here regularly as further information will be provided as it becomes available.