Bill > SB2093

This bill expands the eligibility for expedited credentialing for healthcare providers working with Medicaid managed care organizations and managed care plan issuers. Specifically, the bill broadens the definition of who can qualify for expedited credentialing to include not just established healthcare provider groups, but also federally qualified health centers (FQHCs) and medical groups designated by the Health Resources and Services Administration. The legislation establishes a streamlined process where providers must be Medicaid-enrolled, submit required documentation, and agree to contract terms. Managed care plan issuers are now required to confirm application completeness within five business days, render a credentialing decision within ten business days, and treat applicants as participating providers during the credentialing process, including making in-network payments. The bill also protects enrollees from being charged additional fees if a provider is ultimately determined to be ineligible and limits the liability of managed care plan issuers who follow the new credentialing procedures. These changes aim to simplify and accelerate the provider credentialing process, particularly for healthcare providers associated with federally qualified health centers, potentially improving access to healthcare services. The bill is set to take effect on September 1, 2025.

Health and Social Services

https://capitol.texas.gov/BillLookup/History.aspx?LegSess=89R&Bill=SB2093