Medicaid and CHIP

  • Medicaid Kills Proposed Rule That Would Have Restricted Supplemental Funding, Services

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    The Centers for Medicare & Medicaid Services on Monday withdrew a proposed rule that would’ve restricted how states fund their share of Medicaid, causing serious cuts in services.

    TMA Applauds the Administration's Decision  
  • Texas Medicaid, CHIP Changes Extended Into October

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    As requested by the Texas Medical Association, the Health and Human Services Commission (HHSC) has extended some Medicaid and Children’s Health Insurance Program (CHIP) flexibilities through Oct. 23. 

    Learn More About the Extension  
  • Which Plans Pay for Telemedicine Services – and for How Long?

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    As you’re no doubt aware, telemedicine has made it possible for many physicians to continue seeing patients while reducing the risk of spread during the COVID-19 pandemic.

    Temporary changes to state and federal rules, particularly regarding payment for services, have helped push up the new demand for and use of telemedicine. 

    Find Out What Each Type of Plan Pays for Telemedicine Services  
  • How Health Plans Are Covering COVID-19 Testing and Treatment

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    Many health insurers in Texas are waiving patient costs associated with COVID-19. Last week in a news release, Gov. Greg Abbott and the Texas Department of Insurance asked insurers and HMOs to cover testing consistent with Centers for Disease Control and Prevention guidance, and telemedicine visits.

    COVID-19 and Health Plans: What's Covered?  
  • Payer Policies for Telemedicine Services


    In the wake of COVID-19, TMA is getting calls about which payers are covering telemedicine. TMA developed this quick reference guide to help you navigate telemedicine reimbursement. This table now reflects Medicare’s waiver of the geographic and place of service restrictions for Medicare (which means patients can now be at home).

    Additionally, the Governor directed TDI to issue an emergency rule related to the payment of telemedicine to allow state-regulated plans (about 20% of the commercial market in Texas) to allow telephone and telemedicine visits to be paid at the same rate as in-office visits. If you are not sure which patients are regulated by TDI, check this guide.  Stay tuned for more detail.

    Updated July 27, 2020

    View the Chart  
  • Feds Approve Texas’ Request for COVID-19 Medicaid Waiver

    COVID-19 Medicaid Waiver  

    The Centers for Medicare & Medicaid Services (CMS) on March 30 approved Texas’ request to waive certain Medicaid regulatory requirements to help physicians and other health care professionals more effectively respond to the COVID-19 pandemic.

    Learn About the Medicaid 1135 Waiver  
  • Medicine Pushes Texas Medicaid to Help Save Primary Care


    Leaders of the Texas Medical Association and four large primary care specialty societies on Wednesday painted for senior Medicaid officials the bleak fiscal picture of many physician practices, and requested immediate financial assistance.

    Read the Wish List  
  • Federal Funding for Women’s Health Services in Texas Restored

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    Texas will again receive matching federal funds for women’s health services through a Medicaid 1115 waiver Gov. Greg Abbott announced Wednesday.

    More About the Agreement  
  • Medicine Pushes For Expanding Medicaid Coverage to New Moms

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    Federal lawmakers must pass a bill that would allow states to provide 12 months postpartum coverage to mothers who lose Medicaid coverage two months after giving birth, and would provide a bump in Medicaid matching dollars for those states, medicine and others said in a letter this week.

    Give New Mothers
    a Fighting Chance
  • Legislative Wins on Medicaid: Reforms, But No Raise

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    Medicine didn’t get everything it needed from lawmakers for Medicaid, including TMA’s biggest and boldest ask of the 2019 session. Still, progress TMA achieved on managed care reform and other facets of Medicaid will advance physicians’ efforts to care for the most vulnerable Texans.

    Charting Medicine's Statehouse Progress: Medicaid  
  • Healthy Vision 2025 Provides Medicaid, Uninsured Fixes

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    The combination of the country’s highest uninsured rate and a stressed Medicaid program threaten not only the health of millions of Texans, but also the health of the economy, Texas Medical Association President Doug Curran, MD, says.

    Make It Easier for Every Texan to See a Doctor  
  • Doctors, Insurers, Hospitals Meet to Set Priorities for Strengthening Medicaid Managed Care

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    As the future of Texas Medicaid promises to be a central topic of discussion in the 86th Texas Legislature, leaders from three pillars of the Texas health care system gathered in Austin on Oct. 12 for a first-ever summit to identify and commit to working on shared priorities for strengthening the program.

    Key Players Outline Plans to Strengthen Medicaid  
  • How Do Medicaid Managed Care Organizations Affect You?

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    If you’ve followed the news recently, you’ve probably seen stories highlighting the struggles Texas physicians and patients are having with Medicaid Managed Care Organizations (MCOs).

    Texas' System Faces Grave but Surmountable Challenges  
  • Remodeling Medicaid

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    House calls, yoga classes, and community networks are among the value-based innovations making Medicaid more patient-centered and more penny-wise.

    Is There Value in Medicaid Value-Based Payment?  
  • Medicaid HMO Credentialing – and Recredentialing – Just Got Easier

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    A new collaboration by the Texas Medical Association and the Texas Association of Health Plans (TAHP) called the Texas Credentialing Alliance has streamlined a process that has long frustrated physicians because of its bureaucratic redundancy.

    More About the Collaboration  
  • TMA: Medicaid Patients Could Lose Access to Clinical Tests  

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    Medicaid patients in several states, including Texas, might not receive needed clinical tests because of new payment rates mandated by a federal law named, ironically, the Protecting Access to Medicare Act (PAMA).

    Get the Details  

    TMA is helping to strengthen your practice by offering advice and creating a climate of medical success across the state. 

  • What could a TMA membership mean for you, your practice, and your patients?