Provider Alert! Texas Medicaid and Healthcare Partnership (TMHP) Provider Enrollment and Management System (PEMS)

Date: November 29, 2021

Attention: All Providers

Effective Date: December 13, 2021 for PEMS
Webinar date: December 7, 2021

Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated to the COVID-19 event.  TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event.

Call to action: Texas Children’s Health Plan would like to remind providers that the Texas Medicaid & Healthcare Partnership’s (TMHP) Provider Enrollment and Management System (PEMS) is coming soon. Provider enrollment functions will be available through PEMS, and providers must use the new system to enroll in Texas Medicaid. The benefits of PEMS are as follows:

• The new system will be the single tool for provider enrollment, reenrollment, revalidation, and maintenance requests (maintaining and updating provider enrollment record information).
• PEMS will automate and streamline the provider enrollment process by removing the requirement to use paper forms, simplifying the process for providers to complete their National Provider Identifier (NPI)-based enrollment.
  Providers or individuals who do not provide health-care services and are not required to have NPIs may have been issued Atypical Provider Identifiers (APIs). These providers should use their APIs.

Resource: The Benefits of PEMS (tmhp.com)

Webinar information: The Texas Medicaid & Healthcare Partnership (TMHP) is hosting a Provider Enrollment and Management System (PEMS) provider webinar
When: December 7 from 10 a.m. – noon

Where: To register for the upcoming PEMS webinar visit: https://www.tmhp.com/news/2021-11-05-register-now-pems-provider-webinar

The webinar will cover the following topics:

• What providers need to know before accessing PEMS, such as what PEMS is and information on TMHP User Accounts and the Message Dashboard
• How to use PEMS
• How to submit an application or request
• What to do after providers submit their application through PEMS

More information on PEMS can be found at Provider Enrollment | TMHP.

How this impacts providers: Providers should plan for the following changes on December 13, 2021:

• PEMS will replace Provider Enrollment on the Portal (PEP) and the Provider Information Management System (PIMS).
• PEP and PIMS will no longer be available.
• Paper applications for Texas Medicaid provider enrollment will be eliminated with the new online system.
• Providers must have access to the internet to utilize PEMS and use up-to-date internet browsers for optimum performance of the PEMS portal. Google Chrome or Microsoft Edge is recommended to reduce compatibility issues.

Next steps for providers:  Providers should register to attend the webinar scheduled for December 7 hosted by TMHP, https://www.tmhp.com/news/2021-11-05-register-now-pems-provider-webinar.

Additional guidance:

• Portal Account Information- Providers should ensure that demographic and account information is kept up-to-date with the most current provider data.
• National Provider Identifier and Taxonomies- Providers should verify that provider information on file and taxonomies match when enrolling in PEMS.
• Taxonomy Attestation- The Centers for Medicare & Medicaid Services (CMS) assigns NPIs to clinicians through the National Plan and Enumeration System (NPPES). NPIs are used to track health care providers for billing and quality reporting. The Health and Human Services Commission (HHSC) is asking all providers with Medicaid enrollment to visit NPPES to ensure all taxonomies used to bill for Medicaid services are attested to the providers’ NPI.

If you have any questions, please email Health and Human Services Provider Enrollment at:
providerenrollmentmanagementsystems@hhs.texas.gov

For access to all provider alerts, log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.