THCA

Volume XXXI, Number 5
May 2016

Nursing Facility Re-Enrollment — Avoid Medicaid Provider Disenrollment

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.

To avoid disenrollment on September 25, 2016, and possible disruption in claims payment, providers should submit a re-enrollment application to the state or TMHP today.

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. All providers, including ordering and referring providers, who have not met all PPACA revalidation requirements must do so through re-enrollment by September 24, 2016.

To avoid potential disruption in payment, a complete re-enrollment application must be received on or before June 17, 2016, in order to be revalidated by September 24, 2016. Providers should submit a re-enrollment application to the state or TMHP today.

NOTE: 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.

Applications Received After June 17, 2016

Texas Medicaid will normally process complete applications received on or after June 17, 2016; however, Texas Medicaid cannot guarantee that those applications will be completely processed by the September 24, 2016 deadline. If final approval on an application received after June 17, 2016, is not completed by September 24, 2016, the provider will be disenrolled from Texas Medicaid.

Acute Care providers re-enrolling through TMHP CLICK HERE

DADS Provider Forms CLICK HERE

In TMHP – Under your account, there are 3 sections:

If you have the first section shown above (Acute Care NPI/API) you will use this section to re-enroll

If you DO NOT currently have this section, you must go thru DADS.

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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.