Medicaid

Texas Safety-Net Programs Tied to 1115 Waiver Get New Life – for One Year - 09/10/2021

A key component of Texas’ safety net for low-income people remains intact – for at least another year – thanks to an agreement between the Texas Health and Human Services Commission (HHSC) and the Centers for Medicare & Medicaid Services (CMS) to extend three federally funded programs that were set to expire.


Medicaid Relaxes Prior Authorization for Hep C Antiviral Drugs - 09/06/2021

For years, Texas Medicaid patients with hepatitis C haven’t had access to overwhelmingly effective, often-curative antiviral therapy unless they had advanced liver disease. In many cases, getting the antiviral drugs at that point was too little, too late.


Billing for Telemedicine During COVID-19 - 09/06/2021

COVID-19 prompted an increased need for telemedicine services to connect physicians with their patients. To quickly meet that need, Texas Medicaid adopted waivers and changed policies to ease technology restrictions and expand the number of Medicaid services available virtually. Reimbursement for telemedicine and telehealth averaged less than $800,000 per month in 2019. By April 2020, Medicaid payment for virtual services jumped to $43 million, and averaged more than $37 million monthly throughout 2020.


Data Driven: Medicaid’s Inspector General Focuses on Fraud Prevention, Not Just Prosecution - 09/06/2021

Since her appointment in 2018, Texas Health and Human Services Inspector General Sylvia Hernandez Kauffman has homed in on using data analytics not only to prosecute fraud, waste, and abuse within the Medicaid program, but also to prevent it from happening in the first place. Texas Medicine spoke to Ms. Kauffman about what appears to be a shift in tone from this department as it also focuses on using the data it collects to educate physicians and other health care professionals on common billing mistakes.


Help Louisiana Medicaid Patients Affected by Hurricane Ida - 09/02/2021

If you’d like to lend medical services to people from Louisiana affected by Hurricane Ida, the Texas Health and Human Services Commission (HHSC) has released information on how Texas physicians can help Louisiana Medicaid recipients.


Keeping the Safety Net Open: Restoring the 1115 Medicaid Waiver - 08/02/2021

After CMS revokes extension of 1115 waiver, TMA lobbies for a broader, better version.


Medicaid EHR Incentive Program Deadline Coming Up - 07/28/2021

Participants in the Medicaid Electronic Health Record (EHR) Incentive/Promoting Interoperability (PI) program have one month from today to attest to meeting the program requirements – but don’t wait until the last minute.


Medicaid Relaxes Prior Authorization for Hep C Antiviral Drugs - 07/14/2021

For years, Texas Medicaid patients with hepatitis C haven’t had access to overwhelmingly effective, often-curative antiviral therapy unless they had advanced liver disease. In many cases, getting the antiviral drugs at that point was too little, too late.


TMA Shooting for Reinstatement of 1115 Waiver Extension - 07/08/2021

Facing a major setback for uncompensated care, the Texas Medical Association is taking the opportunity to think bigger and better.


Physician-Led Results: Big Steps Forward in Medicaid, Maternal Health - 06/23/2021

One of the Texas Medical Association’s biggest wins this session came in the partial realization of medicine’s longtime advocacy to extend Medicaid coverage for postpartum maternal care.


Longer Coverage, Longer Lives: COVID-19 Relief Bill Could Help With Medicaid Postpartum Coverage - 05/24/2021

TMA urges Texas to keep pregnant women on Medicaid 12 months postpartum following federal enticement in COVID-19 relief bill.


Feds’ Withdrawal of Texas’ Medicaid Waiver Extension Raises Concerns Over Future Safety-Net Funding - 04/19/2021

The Centers for Medicare & Medicaid Services (CMS) on Friday announced the withdrawal of its Jan. 15, 2021, approval to extend Texas Medicaid’s 1115 Transformation Waiver for 10 years.


Legislative Hotline: Medicaid Continuous Coverage Measures Advance - 04/06/2021

The House Human Services Committee this morning OK’d legislation supporting TMA’s longstanding goals to extend Medicaid coverage for both pregnant women and children.  


Medicaid to Increase Payment Per COVID-19 Vaccine Dose - 04/05/2021

Starting April 1, Medicaid began paying physicians and practices that administer COVID-19 vaccines $40 per dose to align with Medicare’s payment policy announced last month, the Texas Health and Human Services Commission (HHSC) announced.


New Rules Could Make It Harder to Enroll in Healthy Texas Women - 04/01/2021

Healthy Texas Women (HTW) has changed how it determines eligibility for low-income women who use the program, which could put a greater burden on physicians and other health care professionals who help patients get and stay with these services, TMA says.  


Another Poll Shows Texans Overwhelmingly Support Medicaid Expansion - 03/18/2021

Almost 70% of Texans say the state should expand Medicaid to provide health insurance to low-income people who are uninsured, according to a recently released state survey, up from 64% in a similar 2019 poll.


CMS Open Payments Registration Under Way - 02/04/2021

Registration is now open for the Centers for Medicare & Medicaid Services’ (CMS) Open Payments Program, which requires CMS to publicly report data on items of value given annually to physicians and teaching hospitals.


A Case for More Coverage: Studies Suggest Medicaid Expansion Would Fiscally Benefit Texas - 11/12/2020

Two recent studies suggest expanding Medicaid will not only save Texas money, but add to the Lone Star State’s coffers.


Expanded State Services for Some New Mothers Now Available - 10/22/2020

Certain new mothers in Texas are now eligible for expanded care through Healthy Texas Women (HTW) after the first 60 days of giving birth, including treatment for postpartum depression and substance use disorder.


Work to Expand Medicaid, Protect Telemedicine, Speakers at TMA Tele-Town Hall Say - 09/18/2020

Texas physicians need to lobby state and federal lawmakers as soon as possible to prevent cuts in important state services, to encourage the expansion of Medicaid, and to preserve gains made in telemedicine, a panel of speakers told participants in a telephone town hall sponsored Thursday by the Texas Medical Association’s Border Health Caucus.


Medicaid Kills Proposed Rule That Would Have Restricted Supplemental Funding, Services - 09/15/2020

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.


Medicaid Changing Prior Authorization Criteria for Certain Opioid Prescriptions - 08/28/2020

Beginning Sept. 1, Texas Medicaid will implement updated clinical prior authorization criteria for opioid prescriptions for certain Medicaid fee-for-service and managed care patients.


Don’t Delay. Medicaid and CHIP Relief Fund Process Can Be Lengthy - 08/17/2020

Although the deadline for physicians who treat Medicaid and Children’s Health Insurance Program (CHIP) patients to apply for federal Provider Relief Funds has been extended to Aug. 28, health officials recently emphasized that physicians apply as soon as possible because each practice's Taxpayer Identification Number (TIN) must be validated, if it hasn't already. The process can take up to 10 days. CMS also recently made important changes to the eligibility criteria.


Medicaid Grant Could Pay for Your HIE Connection - 08/12/2020

Have you or your practice been considering connecting your electronic health record (EHR) to a health information exchange (HIE), but keep getting hung up by the cost? Well, here’s some good news. Three public HIEs recently were awarded contracts for a Medicaid grant that could pay for you to connect to their exchanges.


Leadership by Fire: Stephanie Stephens New Texas Medicaid, CHIP Director - 08/03/2020

Stephanie Stephens received a not-so-welcome gift entering her new job running Medicaid operations for the nation’s second-largest state: A global pandemic. In that sense, the universe wasn’t easy on Ms. Stephens, the new director of Medicaid and CHIP for the Texas Health and Human Services Commission (HHSC).