Members,
Late Friday, TMHP released
THIS NOTICE which details their planned actions to assist providers who have been negatively impacted by the revalidation process.
Effective December 13, 2024, providers will receive an additional 180 calendar days to complete revalidations PEMS. TMHP and HHSC are also developing a process to address enrollment gaps for providers that have been disenrolled for failing to revalidate timely.
These flexibilities are currently planned to last through May 31, 2025.Per the notice, PEMS will automatically add 180 calendar days to the revalidation due date. This will be reflected in the Revalidation Due Dates found on the Provider Information page in PEMS.
If you've already been disenrolled, TMHP and HHSC are developing a process to modify enrollment period effective dates for providers that:
- Have been disenrolled for failing to revalidate timely between November 1, 2023, and December 12, 2024.
- Successfully reenroll in Texas Medicaid.
For providers that meet both of these criteria, the provider's enrollment period effective date will be backdated up to 365 days to reduce or eliminate their enrollment gap.
TMHP and HHSC expect this process to be implemented in early 2025 and will provide additional information and timelines when available.
Additionally, HHSC is working with TMHP and MCOs to provide additional guidance on claims filing in relation to retroactive enrollment period effective dates.
Please see the entire notice (linked above) for additional details and information.
We know many of you have been severely negatively impacted by the revalidation process and are in the process of trying desperately to get either revalidated or re-enrolled. This notice is good news, however, please continue to communicate your needs/issues/concerns with us so we can continue to assist until these corrective measures are put in place.
Jennifer Elder
Director of Regulatory Affairs