Background: HHSC Provider Finance Department contracted with a third-party vendor, Deloitte Consulting, to develop recommendations for a new rate methodology for Assisted Living Facility (ALF). Action and Key Details: MCOs should inform contracted ALF by Oct. 29 that...
Background: HHSC Provider Finance Department contracted with a third-party vendor, Deloitte Consulting, to develop recommendations for a new rate methodology for all Financial Management Services Agency (FMSA). Action and Key Details: MCOs should inform contracted...
Background: 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...
Background: As a follow-up to the MCO Notices released March 25, 2021, and April 26, 2021, HHSC reminds MCOs that non-local mental health authority (non-LMHA) providers must bill mental health targeted case management and mental health rehabilitation (MH TCM/MHR)...
Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to eligible clients. Administrative procedures such as prior authorization, pre-certification, referrals, and claims/encounter data filing may differ...
These Medicaid and CHIP flexibilities have been extended through August 31, 2021. MCO Notices with Flexibilities to End or That Have EndedThis includes flexibilities that: Are ending August 31, 2021. Have ended on July 31, 2020; October 23, 2020; November 30, 2020;...
