(a) To apply for enrollment or re-enrollment, an applicant
or re-enrolling provider must:
(1) meet the requirements outlined in §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 §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 42 CFR §455.460 in an amount determined
by 42 CFR §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 42 CFR §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.
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