Act Now to Avoid Losing Your Medicaid Enrollment Status
Thanks to lobbying from TMA and organized medicine,
the Centers for Medicare & Medicaid Services extended the
deadline for physicians and other health professionals, including
advanced practice nurses and physician assistants, to reenroll in
Medicaid to Sept. 25, 2016. The initial deadline for reenrollment,
driven by a provision in the Affordable Care Act, was March 24.
According to the Texas Health and Human Services
Commission (HHSC), all physicians participating in Medicaid who have
not met all ACA revalidation requirements must do so through reenrollment by Sept. 24,
2016. To avoid disenrollment and possible claims payment disruption,
Texas Medicaid officials urge physicians to submit a
reenrollment application before June
The reenrollment requirement applies to physicians and
other health professionals who participate in Medicaid managed care,
traditional fee-for-service Medicaid (each active Texas Provider
Identifier suffix), the Texas Vendor Drug Program, and in long-term
care services administered through the Texas Department of Aging and
If an application has deficiencies but is submitted by
June 17, HHSC says there will not be gaps in payment after Sept. 24,
if the physician makes a good faith effort to resolve application
errors. Applications submitted after June 17 will be processed, but
HHSC cannot guarantee those applications will be completed by Sept.
24, which could result in physician disenrollment from Texas Medicaid
and denial of payment.
TMA and Texas Medicaid officials encourage Texas
physicians to get ahead of the complex reenrollment process.
here for more information.