- THCA

Volume XXXI, Number 6
June 2016

URGENT: Action Required Today

THCA was just notified by HHSC that only 35% of Nursing Facility providers have successfully completed the Re-Enrollment process. As a requirement of the Patient Protection and Affordable Care Act (PPACA), state Medicaid agencies must revalidate the enrollment of all providers in state Medicaid programs.

Texas Medicaid & Healthcare Partnership (TMHP) must receive all applications by June 17, 2016 to ensure the re-enrollment process can be completed by the deadline and payments to providers can be continued.

Although you are currently a credentialed provider with a Medicaid MCO, you must still submit the re-enrollment application to TMHP by June 17, 2016 in order to guarantee reimbursement for dates of service prior to and after September 25th 2016. In addition, there is no guarantee applications submitted after June 17 will be processed by September 24, 2016. Nursing Facility payments will cease to Nursing Facilities not re-enrolled by this date.

Where Do I Go to Re-enroll?

TMHP has portals for both long-term care and acute care.

If the nursing facility has a TPI number, the facility must re-enroll through TMHP.

If the nursing facility does not have a TPI number, the facility must enroll through DADS.

Acute Care providers re-enrolling through TMHP CLICK HERE.

DADS Provider Forms

How Can I Find Out If My Facility Is Compliant?

TMHP: 1-800-925-9126

Option 3: Provider Enrollment – The Provider Enrollment line assists with applications to enroll, updates to new and existing provider accounts, and questions concerning enrollment policy. Some of the responsibilities include the following: maintenance of provider accounts, advising providers on how to complete a Texas Medicaid program application, and answering questions regarding policies which impact enrollment.

DADS: LTSS providers who are unaware of their DADS contract status may contact DADS at Texas.Medicaid.Enrollment@dads.state.tx.us to verify contract status and establish next steps.

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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.