Current through Reg. 49, No. 38; September 20, 2024
(a) To apply
for enrollment or re-enrollment, an applicant or re-enrolling provider must:
(1) meet the requirements outlined in §
RSA
352.5 of this chapter (relating to Provider
Enrollment Requirements) and Chapter 371 of this title (relating to Medicaid
and Other Health and Human Services Fraud and Abuse Program
Integrity);
(2) complete an
enrollment application in accordance with the criteria specified by HHSC or its
designee and the instructions contained in the application;
(3) submit a supplemental application form or
forms for any new practice location in accordance with the criteria specified
by HHSC and the instructions contained in the form;
(4) submit an application fee for each
practice location, as described in subsection (b) of this section;
(5) submit documentation to show proof of
registration and good standing with the Texas Comptroller of Public Accounts,
the Texas Secretary of State, or any other documentation requested by HHSC or
its designee, as applicable;
(6)
provide a copy of a surety bond obtained pursuant to §
RSA
352.5 of this chapter;
(7) certify that the information contained in
the application is true and accurate to the best of the applicant's or
re-enrolling provider's knowledge; and
(8) submit a signed provider agreement with
each enrollment application. By signing the provider agreement, the applicant
or re-enrolling provider acknowledges that the applicant or re-enrolling
provider will comply with all terms and conditions of the provider
agreement.
(b) If an
applicant or re-enrolling provider must pay an application fee pursuant to
RSA 455.460 in an
amount determined by
RSA 424.514, the
applicant or re-enrolling provider must submit:
(1) the application fee; or
(2) documentation showing proof of payment of
the application fee within the current enrollment period (as defined by
RSA
424.515) under Title XVIII or any other
state's program under Title XIX or Title XXI of the Social Security
Act.
(c) An applicant or
re-enrolling provider must provide all additional information requested by HHSC
or its designee in connection with the processing of the enrollment
application, by the deadline and in the manner indicated in the request. If the
applicant or re-enrolling provider fails to comply with this requirement, the
enrollment application will be closed.
(d) If an applicant or re-enrolling provider
fails to meet any of the requirements in this section, HHSC or its designee
will consider the enrollment application incomplete and the application will
not be processed.
