Streamlining Provider Enrollment and Credentialing Processes

Sec. 532.0151. STREAMLINING PROVIDER ENROLLMENT AND CREDENTIALING PROCESSES. (a) The commission shall streamline Medicaid provider enrollment and credentialing processes. (b) In streamlining the Medicaid provider enrollment process, the commission shall establish a centralized Internet portal through which providers may enroll in Medicaid. (c) In streamlining the Medicaid provider credentialing process, the commission may: (1) designate a centralized credentialing entity; (2) share information in the database established under Subchapter C, Chapter 32, Human Resources Code, with the centralized credentialing entity; and (3) require all Medicaid managed care organizations to use the centralized credentialing entity as a hub for collecting and sharing information. (d) The commission may: (1) use the Internet portal created under Subsection (b) to create a single, consolidated Medicaid provider enrollment and credentialing process; and (2) if cost-effective, contract with a third party to develop the single, consolidated process. Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.