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December 2016 Texas Medicaid Provider Procedures Manual

Section 1: Provider Enrollment and Responsibilities : 1.1 Provider Enrollment and Reenrollment : 1.1.5 Affordable Care Act of 2010 (ACA) Enrollment Requirements

Providers are required to fulfill certain requirements for enrollment in order to comply with the provisions of ACA. Providers that are enrolled in Texas Medicaid and have fulfilled the ACA requirements through their Texas Medicaid enrollment are considered ACA-compliant for all programs in which they are enrolled.
Refer to:
TMHP website at for additional information about ACA requirements.
In accordance with Section 6401 of ACA, the following requirements apply:
Upon initial enrollment and upon re-enrollment, all participating providers are screened based on their categorical risk level. (complies with 42 CFR §§455.410 and 455.450)
Institutional providers who are enrolling or re-enrolling are required to pay an application fee if one has not already been paid to Medicare or another state’s Medicaid program or Children’s Health Insurance Program (CHIP).
Refer to:

Texas Medicaid & Healthcare Partnership
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