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...
Information posted December 2, 2016Note: This article applies only to claims submitted to TMHP for processing. Refer to the Medicaid managed care organizations (MCOs) for information about MCO benefits, limitations, prior authorization, reimbursement, and MCO specific...
Program providers, financial management services agencies (FMSAs) and Consumer Direct Services (CDS) employers should not submit Visit Maintenance Unlock Requests (VMURs) for dates of service prior to going live with HHAeXchange or their EVV proprietary system. HHSC...
Effective November 22, 2021, licensed behavior analysts (LBAs) must attest to where services will be provided so that the Texas Health and Human Services Commission (HHSC) can determine applicable site visit requirements for enrollment in Texas Medicaid. This change...
Your Patients’ Medicaid Coverage May Be Impacted by the End of the COVID-19 Public Health Emergency Continuous Medicaid Coverage May End Soon Your patients’ Medicaid coverage may be impacted by the end of the COVID-19 federal public health emergency (PHE). Medicaid...
Beginning Sept. 1, 2022, Texas Medicaid will designate one medication as the primary preferred direct-acting antiviral (DAA) drug option for treating Hepatitis C infection. HHSC will designate all other DAA drugs on the Medicaid formulary as non-preferred. All...