Effective January 1, 2026, and applicable to all Community First Marketplace plans (University Community Care Plan), a patient’s health plan of record at the date of an inpatient admission is responsible for payment of all covered inpatient facility and professional...
Provider News
Application Notice for Physicians and Providers to Contract with Community First
Community First Health Plans, Inc. is accepting applications from physicians and providers who wish to participate in its Commercial HMO network. Applicants must meet the practice standards, qualifications, and other participatory criteria established by Community...
Newborn Medicaid Coverage Notice – Effective January 1, 2026
In accordance with House Bill 3940 (89th Legislature, Regular Session), effective January 1, 2026, Providers are required to distribute updated information regarding Newborn Medicaid Coverage to the parent or caregiver of a newborn child. Key Details: Newborns are...
Community First Health Plans to Partner With Cotiviti for Payment Integrity Implementation
Updated January 20, 2026: Community First's partnership with Cotiviti will now launch on June 1, 2026. Please read the notice below for full details. Over the past several years, Community First Health Plans has been implementing payment policies that reflect...
Revalidation Due Dates and Retroactive Enrollment Period Gap Closures Extended
Community First Health Plans is sharing important updates regarding extensions to revalidation due dates and enrollment period gap closures. These changes, offered by the Texas Health and Human Services Commission (HHSC) and the Texas Medicaid & Healthcare...
EVV Impacts Due to Discontinuation of Dual Demonstration Pilot Program
Beginning January 1, 2026, the Health and Human Services Commission (HHSC) will end the Dual Demonstration Program and transition Medicare-Medicaid Plans (MMPs) to integrated Dual Eligible Special Needs Plans (D-SNPs). Members currently enrolled in MMPs will move to a...
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