Federal law and regulation requires states to screen and enroll
all network providers including Children’s Health Insurance
Program (CHIP) providers by December 31, 2017. To meet this
requirement and continue receiving reimbursement for services,
providers who currently render services to CHIP members through
a managed care organization (MCO) must complete enrollment with
the Texas Medicaid & Healthcare Partnership (TMHP) by December
While the enrollment process and application are the same for
Medicaid and CHIP providers, CHIP-only providers are not
required to participate in Texas Medicaid. CHIP-only providers
must follow the instructions below to indicate they intend to
serve only CHIP members and to ensure that they do not appear on
the Medicaid online provider lookup (OPL).
: CHIP providers actively enrolled with TMHP as
a Medicaid provider do not need to repeat the enrollment process
to continue to receive reimbursement for CHIP services.
Enrollment Information Specific to CHIP Providers
Effective July 1, 2017, providers can indicate in the enrollment
application that they intend to serve only CHIP members.
Providers must document this appropriately to ensure they are
not displayed as a Medicaid provider on OPL.
CHIP providers are encouraged to enroll using the
Provider Enrollment on the Portal (PEP)
. Additionally, the
Provider Information Management System (PIMS)
updated with options for providers to designate that they intend
to serve only CHIP members.
Providers should begin the enrollment process as soon as
possible. The PIMS update will allow providers who start the
enrollment process before these updates occur to designate
themselves as CHIP-only providers on the OPL after they are