Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to Medicaid members who are enrolled in their MCO. Administrative procedures, such as prior authorization, precertification, referrals, and claims and encounter data filing, may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the member’s specific MCO for details.
Effective June 30, 2023, the Texas Medicaid & Healthcare Partnership (TMHP) will add clarification to the Provider Enrollment and Management System (PEMS) about the information that is required to complete a change of ownership (CHOW). This change applies only to CHOW requests submitted on or after June 30, 2023. Clarification will be added to the following items:
- The CHOW question “Are you seeking enrollment or updating your enrollment due to a change of ownership?”
- Seller information
- Assumption of Liability
As part of the CHOW submission, TMHP will collect which Medicare numbers are being retained and which are being retired (if applicable) through newly introduced fields on the Ownership/Controlling Interest Information page in PEMS.
As a reminder, a CHOW can be submitted in the following ways:
- If the buyer or new owner is already enrolled with a National Provider Identifier (NPI) or Atypical Provider Identifier (API) in PEMS, the buyer or new owner must submit an existing enrollment application.
- If the buyer or new owner does not have an existing active enrollment with an NPI/API in PEMS, the buyer or new owner must submit a new enrollment application.
After the CHOW application is approved, TMHP will capture the change on the seller or previous owner’s record.
For detailed instructions on how to submit a CHOW, refer to the Ownership/Controlling Interest Information page on the PEMS instructional site. Note: Select the application type from the left navigation menu.
For more information, call the TMHP Contact Center at 800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 800-568-2413.