The U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG) and law enforcement partners have issued an alert regarding fraudulent attempts to reroute Electronic Funds Transfers (EFTs) to fraudulent accounts. Key...
The Texas Health and Human Services Commission (HHSC) is hosting a Provider Enrollment Town Hall Meeting on Thursday, March 27, from 9:00 a.m. to 10:30 a.m. Central Time. This virtual event will feature a presentation on key provider enrollment topics,...
Retroactive Enrollment Periods and Claims Reprocessing The Texas Medicaid & Healthcare Partnership (TMHP) and the Texas Health and Human Services Commission (HHSC) have developed a process to modify enrollment period effective dates for providers that meet the...
In Lieu of Services (ILOS) are services that have been approved by Texas Health & Human Services Commission (HHSC) to be medically appropriate, clinically appropriate, and cost-effective substitutes for covered services under Texas Medicaid. Texas Medicaid...
Effective January 1, 2025, the payers, HHSC and MCOs, will begin EVV Usage reviews to ensure state-required personal care services and home health care services, are in compliance with EVV requirements and policies. Payers will begin contract or enforcement action for...
Texas Health and Human Services Commission (HHSC) and Office of Inspector General-Third Party Recoveries division (OIG-TPR) has recently seen a high number of escalations due to Providers refusing to see a Medicaid eligible Member because the Member has other health...
