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Update: Requirement for Medicaid Nursing Facilities to Enroll in Medicare Prior to Medicaid Enrollment

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Effective Sept. 1, 2025, the Texas Health and Human Services Commission (HHSC) will not require nursing facilities to submit evidence of Medicare enrollment prior to approving Medicaid enrollment. This policy guidance takes the place of guidance issued effective Dec. 2024 and titled “Update: Requirement for Medicaid Nursing Facilities to Enroll in Medicare Prior to Medicaid Enrollment” and subsequent updates.

HHSC is extending the timeline for implementation of the Medicare enrollment requirements for nursing facility providers to align with the implementation of successor liability agreements. HHSC will issue a future notice with the date the agency plans to enforce the requirement that providers delivering services eligible for Medicare reimbursement must enroll in Medicare prior to enrolling in Medicaid.