HB3151

HB3151 expressly includes federally qualified health centers and their healthcare providers in the applicant definition for Texas Medicaid managed-care expedited credentialing. Credentialing is the process a health plan uses to check a provider’s qualifications before admitting it to the network. The act amends an existing provisional-service and reimbursement process rather than creating automatic permanent network membership. Final law.

To qualify, the applicant must have a current Medicaid managed-care contract itself, or be a member of or healthcare provider for an established provider group or federally qualified health center with such a contract. It must also be enrolled in Medicaid, agree to the contract terms, and submit the documentation and information needed to begin credentialing. The federal health-center definition is a specific legal classification, not a label any clinic can choose. Federal definition, 42 U.S.C. 1396d(l)(2)(B).

Under the retained law, the Health and Human Services Commission identifies the provider types for which plans must offer expedited credentialing. After the required submission, a qualifying applicant is treated as in-network for Medicaid reimbursement purposes only while providing services. The plan may later recover the difference between in-network and out-of-network payments if the applicant fails credentialing; fraudulent application claims can allow recovery of the entire amount paid. HB3151 does not remove those safeguards. Credentialing statute.

The governor signed June 20, 2025; the statutory effective date is September 1, 2025. If a state agency determines federal permission is needed for a provision, it must request that permission and may delay that provision’s implementation until permission is granted. Official history.