Bill > HB5512

This bill introduces several key provisions aimed at improving Medicaid provider enrollment, credentialing, and eye health care services. The bill establishes a dedicated support team to assist Medicaid providers with enrollment and credentialing processes, requiring the Health and Human Services Commission to annually evaluate this team's performance and publish a report. Providers will be able to electronically submit complaints and feedback about these processes. The bill also mandates that before disenrolling a provider during their enrollment revalidation period, the commission must provide 30-day written notice and allow the provider an opportunity to address any application deficiencies. For eye health care and vision care services, the bill prohibits Medicaid managed care organizations from using third-party entities to restrict provider network inclusion, limit services, or deny participation for qualified eye health care providers. Additionally, the bill requires that eye health care services providers be reimbursed at rates at least equal to the Medicaid fee-for-service rate. The legislation also modifies existing requirements for managed care organizations to seek participation from and include specific types of healthcare providers in their networks, with a particular focus on ensuring optometrists, ophthalmologists, and related institutions can more easily participate in Medicaid managed care plans. The bill is set to take effect on September 1, 2025, with provisions for seeking federal waivers if necessary.

Health and Social Services

https://capitol.texas.gov/BillLookup/History.aspx?LegSess=89R&Bill=HB5512