1 TAC § 352.7. Applying for Enrollment

(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.