New providers seeking to participate in Texas Medicaid face months of delays in getting clearance from the Texas Health and Human Services Office of Inspector General, according to a source familiar with the applications.
Apparently, some providers have been trying to complete the process since November of last year and are still waiting. OIG is months and months behind.
Applications stalled at OIG
As we understand it, applications clear review by the Texas Medicaid & Healthcare Partnership (TMHP) but remain stalled awaiting OIG clearance. This delay occurs before providers can complete enrollment and is separate from dental maintenance organization credentialing.
One recent update suggested the wait could last “a couple more months,” despite the time already elapsed.
OIG attributes the delays to a backlog, according to our source
. The affected applicants are new providers entering Medicaid for the first time, and the issue extends beyond dentists to other provider types.
Another barrier to participation
For practices preparing to accept Medicaid patients, an indefinite wait creates uncertainty about staffing, scheduling and revenue. Willingness to participate means little if providers cannot get through the approval process.
Screening applicants serves an important purpose. But one has to wonder whether these delays are more of a feature of Texas Medicaid than a bug. We’ve been railing about credentialing delays at DMOs and TMHP for years with little change. Whatever the intent, the effect is to keep willing providers out of the program. Is anyone measuring what that means for patients trying to get care?
For providers waiting to enter Texas Medicaid, OIG clearance appears to be another brick in an already substantial administrative wall.