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IMPORTANT: Medicaid and CHIP Program Revalidation Required for all Providers

Date: 09/18/23

Please note: This article is an update from the previously posted article: Provider Enrollment Revalidation Extensions to End on May 11, 2023

The Texas Health and Human Services Commission (HHSC) waived the requirement for provider revalidation for Medicaid and/or CHIP provider program enrollment during the COVID-19 public health emergency (PHE), which ended effective May 11, 2023.

Beginning May 12, 2023, provider Medicaid and/or CHIP revalidation requirements were resumed. Providers must ensure Medicaid and/or CHIP enrollment revalidation is completed on or before the provider’s scheduled revalidation date. Providers that do not complete the revalidation process by their deadline are disenrolled from all Texas state healthcare programs, including Medicaid and/or CHIP managed care programs.

Superior HealthPlan requests providers visit the Texas Medicaid & Healthcare Partnership (TMHP) Provider Enrollment webpage to view and confirm their upcoming Medicaid and /or CHIP program revalidation date, verify current enrollment is active and verify all information in the PEMS system is accurate.

Please follow the steps below to view and confirm provider enrollment status for Medicaid and/or CHIP:

  1. Go to the TMHP website.
  2. Log in by clicking “My Account.”
  3. Select “Provider Enrollment Management System (PEMS)” located under “Manage Provider Accounts.”
  4. The PEMS Administrator Screen will display “Revalidation Date” for each National Provider Identifier (NPI).
    • Providers can also click on any of the listed NPIs to go to the PEMS information Change Screen.
    • The PEMS Information Change Screen will also display “Revalidation Date.”

Providers who are not actively enrolled in the Medicaid and/or CHIP Program are prohibited from providing services, or receiving reimbursement for covered services for Superior Medicaid and/or CHIP members.

For assistance with Medicaid and/or CHIP enrollment and revalidation, or to confirm your revalidation date for Medicaid and/or CHIP Program enrollment, call the TMHP Contact Center at 1-800-925-9126 or email providerenrollmentmanagementsystem@hhs.texas.gov.

For other questions and assistance, please contact your local Account Manager.