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Background:

HHSC is continuing the roll-out of the Provider Enrollment and Management System (PEMS). Providers must use this new system to enroll. This new system will be the single tool for enrollment, reenrollment, revalidation, and maintenance requests (maintaining/updating provider enrollment record information). PEMS will automate and streamline the provider enrollment process by removing the requirement of the use of paper forms, thereby simplifying the process for providers to complete their National Provider Identifier (NPI)-based enrollment. Upon deployment, PEMS will replace Provider Enrollment on the Portal (PEP) and the Provider Information Management System (PIMS).

Key Details:

The PEMS roll-out will follow a phased approach from September to November 2021 to help aide in the development of the system and ensure the system meets the needs of the providers. PEMS will be available for all providers on December 13, 2021.

Additional Information:

HHSC and TMHP will post more information about the upcoming changes, including provider training and resources prior to implementation.

Resources:

Hyperlink to notice on the TMHP website: https://www.tmhp.com/news/2021-08-03-tmhp-provider-enrollment-and-management-system-pems-roll-out-schedule

Beginning September 1, 2024 Community First Health Plans, Inc. will be adding STAR+PLUS to its line of health care products.

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