HB4123 - Relating to Medicaid provider enrollment revalidation.

  89R9329 LRM-D     By: Guerra H.B. No. 4123       A BILL TO BE ENTITLED   AN ACT   relating to Medicaid provider enrollment revalidation.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Subchapter D, Chapter 532, Government Code, as   effective April 1, 2025, is amended by adding Section 532.01511 to   read as follows:           Sec.   532.01511.     REVALIDATION OF PROVIDER ENROLLMENT. (a)   At least 120 days before the date a Medicaid provider's Medicaid   enrollment period expires, the commission shall provide to the   provider written notice of the upcoming expiration. The notice must   include:                 (1)     the date on which the provider's enrollment will   expire; and                 (2)     information on the process for revalidating the   provider's enrollment, including:                       (A)     the form and manner for applying for   revalidation;                       (B)     the information and documentation the   provider must submit with an application for revalidation of   enrollment; and                       (C)     a suggested timeline for submitting the   application, including the required information and documentation,   to ensure timely reenrollment and avoid disenrollment for failure   to revalidate enrollment before the provider's enrollment period   expires.           (b)     If a Medicaid provider submits an application for   revalidation of enrollment at least 60 days before the date a   Medicaid provider's Medicaid enrollment period expires, the   commission shall conduct an initial review of the application to   determine whether the application contains any obvious   deficiencies. If the commission identifies a deficiency, the   commission shall:                 (1)     notify the provider of the deficiency at least 45   days before the date the provider's enrollment period expires;                 (2)     provide the provider at least 10 days to correct   the deficiency; and                 (3)     if the provider corrects the deficiency within the   time provided under Subdivision (2), complete a full review of the   application before the date the provider's enrollment period   expires.          SECTION 2.  Section 532.01511, Government Code, as added by   this Act, applies only to a Medicaid provider whose enrollment   period expires on or after January 1, 2026.          SECTION 3.  If before implementing any provision of this Act   a state agency determines that a waiver or authorization from a   federal agency is necessary for implementation of that provision,   the agency affected by the provision shall request the waiver or   authorization and may delay implementing that provision until the   waiver or authorization is granted.          SECTION 4.  This Act takes effect September 1, 2025.