Community First will not be requiring authorization for behavioral health services that are managed by and billed by the patient’s PCP. This is part of the Collaborative Care Model (CoCM). Senate Bill 672, 87th Legislature, Regular Session, 2021 directed HHSC to...
There will be revisions to the Electronic Visit Verification (EVV) Policy Handbook, these revisions will publish and be effective on Sept. 1, 2022. The handbook includes EVV standards and policy requirements for: Program Providers Financial Management Services...
As stated in the Community First Provider notice posted on May 11 (“EVV Contract Awarded to Accenture and HHAeXchange”), users of the current EVV vendor systems (DataLogic/Vesta or First Data/AuthentiCare) must transition to HHAeXchange or receive approval as an EVV...
ATTENTION COMMUNITY FIRST PROVIDERS Texas state regulations (Texas Administrative Code §353.502) require MCOs to conduct routine audits of Provider and Member claims to ensure that proper payments are made. If you receive a request for medical records, return...
HHSC will begin collecting cost surveys for the state fiscal year 2022 on June 1, 2023. The purpose of the cost survey is to collect FMSA costs for the state fiscal year 2022 for all FMSAs in Texas. This cost information will be used in the review of current FMSA...
Personal Care Services (PCS) is considered medically necessary when a member requires help with activities of daily living (ADLs), instrumental activities of daily living (IADLs), or health maintenance activities (HMAs) because of physical, cognitive, or behavioral...
