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December 2016 Texas Medicaid Provider Procedures Manual

Section 1: Provider Enrollment and Responsibilities : 1.1 Provider Enrollment and Reenrollment : 1.1.9 Required Enrollment Forms : Copy of License, Temporary License, or Certification
Providers cannot enroll in Texas Medicaid if their license is due to expire within 30 days. During the enrollment process, TMHP verifies licensure using available resources. If TMHP cannot verify a license at the time of enrollment, it is the providers’ responsibility to provide a copy of the active license to TMHP. Psychologists and facilities must submit a copy of their license since these licenses cannot be verified online.
TMHP will notify the provider by letter if a copy has not been submitted and the license cannot be verified.
Once a provider is enrolled in Texas Medicaid the license or certification must be kept current. A reminder letter for renewal will be sent to the provider 60 days before the provider’s license expires.
TMHP directly obtains licensure information from the following licensing boards:
If a license cannot be verified due to a delay in obtaining the board licensing information, providers must request a letter from the licensing board for their individual provider information and submit it to TMHP by the deadline indicated in the reminder letter. The letter must contain the provider’s specific identification information, license number, and licensure period.
All other licenses and certifications that are not issued by TMB, BON, or TSBDE must be submitted to TMHP upon renewal.
Providers are also required to submit to TMHP, within 10 days of occurrence, notice that the provider’s license or certification has been partially or completely suspended, revoked, or retired. Not abiding by this license and certification update requirement may impact a provider’s qualification to continued participation in Texas Medicaid.
Refer to:

Texas Medicaid & Healthcare Partnership
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