TMPPM 2008 > Texas Medicaid Services > Nurse Practitioner (NP) and Clinical Nurse Specialist (CNS) > Enrollment

34.1 Enrollment

To enroll in the Texas Medicaid program, an NP or CNS must be licensed as a registered nurse and recognized as an advanced practice nurse (APN) by the Texas Board of Nursing (BON). A registered nurse under the multi-state licensure compact can be licensed in another state but certified as an APN by the Texas BON for the state of Texas. The Texas Medicaid program accepts a signed letter of certification from the Texas BON as acceptable documentation of appropriate licensure and certification for enrollment.

Providers cannot be enrolled if their license is due to expire within 30 days.

All providers of laboratory services must comply with the rules and regulations of the Clinical Laboratory Improvement Amendments (CLIA). Providers not complying with CLIA are not reimbursed for laboratory services.

All APNs (including certified nurse-midwives [CNMs], certified registered nurse anesthetists [CRNAs], CNSs, and NPs) are enrolled within the categories of practice as determined by the Texas BON. CNSs and NPs must enroll as an APN; CNMs and CRNAs are allowed to enroll using their specific titles. Specific CNM and CRNA enrollment information may be found in the CNM and CRNA sections of this manual.

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 enrollment procedures.

"CLIA Requirements" .

"Enrollment" for more information on certified nurse midwife enrollment.

"Enrollment" for more information on certified registered nurse anesthetist enrollment.