High impact
Update to Medicare Waiver Request Requirements and Language
Texas Medicaid·Effective Jul 31, 2026
Effective July 31, 2026, Medicare waiver request requirements and language in PEMS are being updated. Providers who obtain Medicare certification after Medicaid enrollment must now submit a new Medicaid enrollment application within 10 days listing their complete Medicare information. Additionally, providers with existing Medicare waivers who later provide billable services to Medicare clients must immediately enroll in Medicare and resubmit Medicaid enrollment within 10 days. The waiver request certification statements in PEMS have been revised to clarify these obligations and the requirement to bill all applicable non-Medicaid insurances before Medicaid.