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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 : 1.1.9.12 Federally Qualified Health Center Affiliation Affidavit

1.1.9.12
All FQHC must identify and attest that all contractual affiliation agreements with contracted providers have been submitted to and approved by the Bureau of Primary Health Care (BPHC).
Texas Medicaid defines an affiliate agreement as a contract between an FQHC and another provider for the provision of FQHC services for which the FQHC will bill Medicaid under the FQHC prospective payment system (PPS).
Refer to:

Texas Medicaid & Healthcare Partnership
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