The FMSA and the service provider retain this form during the effect and for five years after. Applicants who do not provide health services (for example. B CDS) are not required to apply for the CPI. Once the contract is concluded, an atypical supplier ID (API) is assigned to each contract instead of an NPI. CDSA applicants can obtain an NPI and do so on the NPPES website. The contract registration process takes approximately 60 days from the date your full application was received by HHS. It is important that you document all the necessary information in a complete and accurate manner. The application process is delayed when your application is returned for corrections. Your application will be processed as part of the order received by HHS. The effective date of the contract is set by HHS, but it will not be at the earliest on the first day of the month following the month following the completion and full completion of the application. Some regions and programs have long lists of interests. Der Vertrag mit HHS garantiert nicht, dass eine Anbieteragentur Empfehlungen erh-lt.

For more information on services, licensing requirements, communication, status and rules, as well as provider manuals, click on the programs on the website of the long-term care provider portal. The FMSA must keep the original for the service provider in its file. A copy is made available to the service provider by the FMSA. Each provider must subscribe to HHS email updates via the link provided on the HHS website and be informed of the content of the e-updates. The link to subscribe to HHS electronic notifications is at the top of each provider`s website. Agreement effective date – Enter the validity date of the service provider agreement. Service provider – Enter the service provider`s name and contact information. If the service provider is an entity, enter the name and contact information of the entity. Health and Human Services (HHS) has 1 standard contract and registration request for all community service providers. The application package consists of a number of necessary forms and documents. 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.

A pharmacy with a license or recent registration to the Texas State Board of Pharmacy or is licensed under the laws of another state and is free from any restrictions of pharmacy administration, may apply to become a supplier to Texas Medicaid pharmacy. Texas pharmacies must register with the Texas Vendor Drug Program before offering outpatient Medicaid services. documenting the agreement between a financial management agency (FMSA) on behalf of the Texas Health and Human Services Commission (HHSC), the state-run Medicaid agency; and a service provider (collaborators, contractors, businesses or sellers) that provides services to one or more people via the Direct Consumer Services (CDS) option. Medical service providers must register with the Texas Medica Medicaid and Healthcare Partnership (TMHP) for title XIX (Medicaid) reimbursement. You`ll find an app under TMHP Provider Enrollment. For more information for TMHP supplier relations representatives in your area, visit TMHP Provider Support Services. Signatures/dates – The service provider and the FMSA representative must sign and date the service provider`s agreement. The FMSA and the service provider are responsible for filling out and processing this form.

All applicants (with the exception of CDSA applicants) must apply for a National Supplier Identification Number (NPI) through the National Plan and Provider Enumeration System (NPPES).