Feb 9, 2023 | Medicaid News, Member News
After a three year pause due to the COVID-19 Public Health Emergency, Texas Health and Human Services Commission (HHSC) is restarting eligibility reviews. If you have Medicaid or CHIP, take these steps to find out if you can keep your coverage. Make sure HHSC has your...
Dec 16, 2024 | Community First Providers, Provider News
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...
Dec 16, 2024 | EVV News, HHSC News, Provider News
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...
Dec 12, 2024 | Provider News, Provider Resource
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...
Dec 6, 2024 | EVV News, Provider News
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...
May 1, 2024 | Member Resource
It never fails. Friday at 5 p.m., your little one spikes a fever, just after the doctor’s office closes. Or you wake up Sunday morning with chills and an awful headache. Sickness and medical emergencies don’t follow a 9 to 5 schedule. It’s important...
Nov 25, 2024 | Provider News
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...
Oct 28, 2024 | Community First Blog
“Education is the most powerful weapon we can use to change the world.” – Nelson Mandela All children have the potential to do extraordinary things! Texas A&M University San Antonio (TAMU-SA) and Community First recognizes the value of higher education to...
Nov 19, 2024 | Provider News
Zelis® is utilizing a maintenance window for the Payspan Portal on Saturday, November 23, 5:00 p.m. (ET) through Sunday, November 24, 8:00 a.m. (ET). Note: If the maintenance activities are completed before 8 AM, we will end the maintenance early. The following System...
Nov 13, 2024 | Provider News
Effective for dates of service on or after December 1, 2024, additional telemedicine and telehealth services will be available for Texas Medicaid clients. Certain telemedicine and telehealth services may be provided if the Provider determines that the services are...
Nov 12, 2024 | Provider News, Provider Resource
Managing asthma in children requires collaboration between health care providers, parents, and caregivers. ALL children with asthma should have an Asthma Action Plan filled out by their healthcare provider. The South Texas Asthma Coalition (STAC) has released a new,...
