Community First Health Plans is sharing important updates based on guidance from the Texas Health and Human Services Commission (HHSC) regarding COVID-19-related coverage. A recent amendment to the federal Public Readiness and Emergency Preparedness Act (PREP Act)...
Community First Health Plans would like to inform providers that the effective date for Provider Enrollment and Management System (PEMS) is now May 30, 2025. The collaborative testing between Managed Care Organizations (MCOs) and Health and Human Services Commission...
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...
HHSC’s Provider Finance Department (PFD) provided Information Letter No. 2024-15 notifying Providers of the 2024 Cost Report and 2024 and 2025 Accountability Report training schedule. Home and Community-based Services (HCS), Intermediate Care Facilities for...
The Texas Health and Human Services Commission (HHSC) is notifying program providers and financial management services agencies (FMSAs) that the Texas Medicaid & Healthcare Partnership (TMHP) has published the Proprietary System Operator (PSO) ORR 2025 Onboarding...
Key Details: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to Medicaid members who are enrolled in their MCO. Administrative procedures, such as prior authorization, precertification, referrals, and...
