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  • Related Content

    • Medicaid HMO Expansion: Are You Ready?
    • The Paper Medicaid ID Is Gone for Good

  • Medicaid/CHIP

    • Medicaid Pic 1 READ MORE

      In Texas and nationally, health care programs for the poor must become more effective, efficient, and accountable.

      The post-9/11 economic downturn increased demand for Medicaid and the Children's Health Insurance Program (CHIP) and cut tax income available to pay for them. In 2004, all 50 states imposed cost controls on the programs.  Lawmakers are rightly concerned about rising enrollment and costs in these programs. Texas physicians recognize the need to assure that Medicaid and CHIP must be more effective, efficient, and accountable. At the same time, these programs are vital to the health and well-being of the state’s poor and low-income families as well as the economic vitality of the state and local governments.

  • Medicaid/CHIP Enrollment

    • Use the following links to learn about enrollment in the Medicaid program.

       

      Texas Medicaid Provider Enrollment – HHSC

      Forms for Medicaid Providers - TMHP

      Medicaid: Beyond the Basics - Participant Guide by TMHP

      Texas Medicaid Provider Procedures Manual – TMHP

       

      CHIP 

      CHIP/Children's Medicaid Online Application 

      Children’s Services Handbook – TMHP

      Medicaid/CHIP Provider Resources

  • Medicaid Managed Care

    • Learn about the Medicaid Managed Care programs with these resources.

       

      Different Types of Medicaid - HHSC

      Medicaid Uniform Managed Care Contract – HHSC

      Medicaid Uniform Managed Care Manual – HHSC

      STAR Medicaid Managed Care – HHSC

      What is Medicaid STAR+PLUS 

      STAR Health Managed Care Contract - HHSC

  • Payment

    • Find out what you need to know about Medicaid reimbursement.

       

      Medicaid Fee Hike Requires Eligibility Confirmation (Action, May 1, 2013)

       Medicaid Bulletin Index 

      Texas Medicaid Reimbursement - TMHP

      Online Medicaid Fee Lookup - TMHP

      Static Medicaid Fee Schedules - TMHP

  • Dual-Eligible Patients

    • What do you need to know about dual eligibility?

       

       Payment for Patients Dually-Eligible for Medicare and Medicaid 

       Dual Eligible Emergency Still Exists 

       Medicaid to Clean Up Dual Eligible Mess 

       Medicaid Coverage of Medicare Beneficiaries (Dual Eligibles) - CMS

  • Resources

    • Below are resources related to the Medicaid/CHIP program.

       

      Texas Medicaid Program Provider Resources – HHSC

      Texas Medicaid/CHIP Vendor Drug Program: Enhanced Formulary Search - HHSC

      Texas Health Insurance Premium Payment (HIPP) Program – Private health coverage through Medicaid

      Message to Medicaid Providers - Speak Up: IMPROVE Gives New Voice to Providers 

      Ask TMA – TMA Knowledge Center

       

      Medicaid Formulary Resources 

      VDP Formulary Search    

      Enhanced Formulary Search   

      Epocrates Free Subscription Formulary Search 

  • Related Links

    • Use these links to access more information on the Medicaid program.

       

      Texas Health and Human Services 

      Texas Health Steps 

      Medicaid.gov

  • Get the Latest News About Medicaid

    • TMA Launches Physician Services Organization for Patient Care
      Texas’ premier physician associations today announced the establishment of an organization to deliver doctors the survival tools they need to provide demonstrably better and more efficient patient care and compete in today’s health care marketplace.   
    • Federal Agency: Physicians Can Begin to Register on CMS Open Payments Website
      Federal Agency: Physicians Can Begin to Register on CMS Open Payments Website
    • Federal Agency: Physician Payments Sunshine Act Data Collection Begins
      Federal Agency: Physician Payments Sunshine Act Data Collection Begins Federal Agency 2013-08-01 In February 2013, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that implements the Physician Payments Sunshine Act, a provision of the Patient Protection and Affordable Care Act (P
    • Texas Needs Health Care Solution for Working Poor
      We hear a lot lately about how Medicaid is broken in Texas. Indeed, many parts of the system are badly in need of repair. When people who work in this building talk about a broken Medicaid system, you’re often talking about its spiraling, unsustainable cost to the taxpayers.
    • Budget, TMA-backed Bills on the Move
      With roughly six weeks to go in the Texas Legislature's 2013 session, lawmakers are near the finish line in drafting a state budget for the next two years. The process has been rather smooth sailing compared with last session as medicine marches closer to accomplishing its goals of reversing the drastic cuts from 2011.

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