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25.3 Outpatient
25.3.1 Enrollment
To be eligible to participate in the Texas Medicaid Program, a hospital must be certified by Medicare, have a valid provider agreement with HHSC, and have completed the TMHP enrollment process.
All providers of laboratory services must comply with the rules and regulations of CLIA. Providers not complying with CLIA will not be reimbursed for laboratory services.
Hospital Eligibility Through Change of Ownership
Under procedures set forth by CMS and HHS, a change in ownership of a hospital does not terminate Medicare eligibility; therefore, Medicaid participation may be continued if the hospital obtains recertification as a Title XVIII (Medicare) hospital and a new Title XIX (Medicaid) agreement between the hospital and HHSC.
Contact the TMHP Contact Center at 1-800-925-9126 to obtain the Medicaid hospital participation agreement.
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