The employer or designated representative (DR) must assist the FMSA in obtaining the required HHSC service contract form with signatures from any service provider (employee, contractor, business or seller) if HHSC requires it. For each service provider paid through the FMSA for one or more people participating in the CDS option, a service provider contract form must be completed. The FMSA and the service provider retain this form during the effect and for five years after. If you have any questions, speak to your local TMHP Supplier Relations Representative. To find your area staff, go to the regional support provider`s registration site or call 800-568-2413. To become a health care facility or ICF/IDD provider, you must first apply for an HHSC license. A new Texas Medicaid applicant must include Form 3684 in the HHSC licensing package. The mailing address of the HHSC licensing package is as follows: Texas Medicaid and CHIP supplier resources contain information on supplier registration and re-registration, rate analysis, the Perinatal CHIP program, physician-administered drugs and communications resources. The positions complete Form 3684 to apply for registration with Texas Medicaid and existing providers for a new registration with Texas Medicaid. A new applicant must register with Texas Medicaid to obtain a Medicaid provider agreement to provide intermediate care or care services for people with mental disabilities (ICF/IID). There is a separate registration process for pharmacy providers. Pharmacies wishing to participate in Texas Medicaid must enroll in the Drug Sales Program before offering outpatient prescription services or participating in a management care network.

After registering with Medicaid, a provider can register with Texas Health Steps. The application form is available for download by TMHP. To qualify for the Texas Medicaid rebate, a medical service provider must: signatures/dates – The service provider and the FMSA representative must sign and date the provider`s agreement. Due to the impact of Hurricane Harvey and the pending clarification by the Centers for Medicare – Medicaid Services, the Texas Health and Human Services Commission delayed the implementation of the necessary registration of all order, reference or prescription providers, which was originally scheduled for October.

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