Beginning December 1, 2025, HHSC is requiring a phased approach to claim edits related to CLIA certification Data: Soft Edit Period (No later than March 1, 2026) A soft edit will be implemented to help providers correct CLIA information that does not match the PEMS...
Provider News
Update: Laboratory Services Require Updated CLIA Certification in PEMS
Read about the Revised Implementation Timeframes of CLIA Certification Data here. All Providers who perform or bill laboratory services must comply with the Clinical Laboratory Improvement Amendments (CLIA). To meet these requirements, Providers must have an active...
New DSHS Resources to Support Congenital Syphilis Prevention and Care
Texas continues to see rising rates of congenital syphilis, highlighting the continued vigilance in prenatal care. Early screening, timely diagnosis, and appropriate treatment during pregnancy are critical to preventing transmission and improving outcomes for infants....
Payspan Portal Production Maintenance – Saturday, February 14, 5:00 P.M. (ET) through 8:00 P.M. (ET)
Dear Valued Zelis® Customer: Zelis® is utilizing a maintenance window for the Payspan Portal from 5:00 P.M. (ET) – 8:00 P.M. (ET) on Saturday, February 14, 2026. Note: We will end the maintenance early if the activities are completed by 8:00 P.M. (ET)....
POSTPONED – Adult Vaccines Added to the Pharmacy Benefit
The Texas Vendor Drug Program (VDP) has notified managed care organizations that the planned expansion of adult vaccine coverage under the Medicaid pharmacy benefit has been postponed and will not go live on February 2, 2026. This update is related to the October 13,...
HHSC Currently Seeking Members for Three Advisory Committees
HHSC is currently seeking members for the three advisory committees listed below. The Intellectual and Developmental Disability System Redesign Advisory Committee (IDD SRAC) advises the Health and Human Services system on the implementation of the acute care services...
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