TX HB586

Licensed behavior analysts who join an established professional practice with an existing managed care plan contract can qualify for expedited credentialing, allowing them to be treated as in-network providers for payment purposes while their full credentialing is processed

To qualify, behavior analysts must be licensed and in good standing with the Texas Department of Licensing and Regulation, submit all required documentation, and agree to comply with the terms of the practice's existing provider contract

During the credentialing process, managed care plans must pay the applicant as an in-network provider and authorize them to collect copayments from enrollees, though the plan may exclude them from provider directories until credentialing is complete

If an applicant ultimately fails to meet credentialing requirements, the managed care plan may recover the difference between in-network and out-of-network payment rates from the behavior analyst or their practice

Enrollees are held harmless and cannot be charged for any difference between in-network and out-of-network costs if a behavior analyst's credentialing is denied