Volume XXXI, Number 4
April 2016

Avoid Being Dis-enrolled from Medicaid

As a requirement of the Patient Protection and Affordable Care Act (“PPACA”), all Texas Medicaid providers, including ordering and referring providers, must revalidate their enrollment in the Texas Medicaid program if they initially enrolled before January 1, 2013. This applies to providers who participate in Medicaid managed care, traditional fee-for-service Medicaid (each active TPI Suffix), the Texas Vendor Drug Program, and in long-term care services administered through the Texas Department of Aging and Disability Services (DADS). Providers can re-enroll through the Texas Medicaid and Healthcare Partnership (TMHP) or through the Texas Health and Human Services Commission.

Medicaid providers are encouraged to submit Medicaid re-enrollment application on or before June 17, 2016. If your application is submitted after June 17, Texas Medicaid can’t guarantee that it will be processed and revalidated by the Sept. 24 deadline, which means you will be dis-enrolled from Texas Medicaid and suffer a gap in enrollment (and thus reimbursements) from September 25, 2016 to the date the application is finally approved.

To avoid potential disruption in payment, a complete re-enrollment application must be received on or before June 17, 2016 in order to be re-validated by September 24, 2016. Complete applications that are received on or before June 17, 2016, will most likely complete the re-enrollment process by September 24, 2016. In the event that the re-enrollment process is not completed by September 24, 2016, and the provider is still working toward addressing identified deficiencies at that time, the provider will continue to remain enrolled in Texas Medicaid as long as the provider continues to respond to deficiency notifications within the defined timeframe for response. Continued enrollment is contingent upon continuing to meet deficiency correction timelines and receiving final application approval.

President’s Report


 Legislative Update


Commitment to Care

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If you have any questions about the THCA Commitment to Care Initiative or would like to share your facilities successes please contact Gloria Bean-Williams by email or call (512) 458-1257.


State / THCA News

  • Avoid Being Dis-enrolled from Medicaid

National / AHCA News


Announcements & Recognition


THCAPAC

?’s About THCAPAC…Contact Us

Ron Payne,
THCAPAC Co-Chair

Mark McKenzie,
THCAPAC Co-Chair

Gina Muniz,
THCAPAC Liaison

Scot Kibbe,
THCAPAC Liaison


Region News


Education


Calendar


Visit, Like and Follow THCA….

Are you familiar with THCA’s Website, Facebook Page & Twitter Account? We utilize these portals to provide information & tools for long term care providers / caregivers, family members, LTC advocates, and to share the wonderful events, celebrations, etc. that take place in Texas Nursing, Rehabilitation & Assisted Living facilities!

Visit our Website, “Like” our Facebook page and “Follow” us on Twitter! And please encourage your staff to as well!

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