The bill, S.B. No. 2093, aims to expedite the credentialing process for certain providers at federally qualified health centers (FQHCs) by managed care plan issuers and Medicaid managed care organizations in Texas. It amends Section 540.0656(d) of the Government Code to specify that to qualify for expedited credentialing, an applicant must be a member of an established health care provider group, a federally qualified health center, or a medical group designated as an FQHC, and must also be a Medicaid-enrolled provider. Additionally, the bill introduces a new Subchapter F to Chapter 1452 of the Insurance Code, which outlines definitions, eligibility requirements, and the expedited credentialing process for FQHC providers.
Key provisions include a requirement for managed care plan issuers to confirm the completeness of an applicant's application within five business days and to render a decision on expedited credentialing within ten business days. The bill also mandates that applicants be treated as participating providers for payment purposes during the credentialing process, allowing them to collect copayments and receive payments for services rendered. Furthermore, it establishes protections for enrollees, ensuring they are not held liable for differences in copayments if a provider is later deemed ineligible. The bill is set to take effect on September 1, 2025, contingent upon any necessary federal waivers or authorizations.
Statutes affected: Introduced: ()