TMPPM 2008 > Texas Medicaid Services > Case Management for Children and Pregnant Women (CPW) > Enrollment

12.2 Enrollment

Enrollment for CPW providers is a two-step process.

Step 1: Potential providers must submit a Department of State Health Services (DSHS) Case Management for CPW provider application to the DSHS Health Screening and Case Management Unit.

Eligible case managers include registered nurses with a diploma, associate's, bachelor's, or advanced degree or social workers with a bachelor's or advanced degree who are currently licensed by their respective Texas licensure board and whose license is not temporary in nature. Eligible case managers must also have at least two years of cumulative, paid, full-time work experience or two years of supervised full-time, educational, internship/practicum experience in the past ten years. The experience must be with children who are up to 21 years of age and/or pregnant women. The experience must include assessing psychosocial and health needs and making community referrals for these populations.

For more information about provider qualifications and enrollment, contact DSHS at 1-512-458-7111, Ext. 2168, visit the case management website at www.dshs.state.tx.us/caseman/default.shtm, or write to the following address:

Case Management
Health Screening and Case Management Unit
1100 West 49th Street, MC-1938
Austin, TX 78756-3199

Note: Before providing services, each case manager must attend DSHS case manager training. Training is conducted by DSHS regional staff.

Step 2: Upon approval by DSHS, potential providers must enroll as a Medicaid provider for CPW and submit a copy of their DSHS approval letter. Facility providers must enroll as a CPW group, and each eligible case manager must enroll as a performing provider for the group. Federally qualified health center (FQHC) facilities that provide CPW services use their FQHC number and will not apply for an additional provider number for CPW.

Important: All providers are required to read and comply with Section 1, Provider Enrollment and Responsibilities. In addition to required compliance with all requirements specific to the Texas Medicaid Program, it is a violation of Texas Medicaid Program rules when a provider fails to provide health-care services or items to Medicaid clients in accordance with accepted medical community standards and standards that govern occupations, as explained in Title 1 Texas Administrative Code (TAC) §371.1617(a)(6)(A). Accordingly, in addition to being subject to sanctions for failure to comply with the requirements that are specific to the Texas Medicaid Program, providers can also be subject to Texas Medicaid Program sanctions for failure, at all times, to deliver health-care items and services to Medicaid clients in full accordance with all applicable licensure and certification requirements including, without limitation, those related to documentation and record maintenance.

Refer to: "Provider Enrollment" for more information about procedures for enrolling as a Medicaid provider.