Medicaid

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).


Portal to Apply for Medicaid and CHIP Relief Funds Open - 06/11/2020

The Department of Health and Human Services (HHS) has opened a portal for physicians who treat Medicaid and CHIP patients to apply for federal emergency assistance related to COVID-19.


Medicine Pushes Texas Medicaid to Help Save Primary Care - 05/08/2020

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.


Feds Approve Texas’ Request for COVID-19 Medicaid Waiver - 03/31/2020

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.


Census Undercount Could Stifle Texas’ Health Services, Doctors Say - 03/11/2020

Texas physicians are urging patients to answer the upcoming U.S. Census to ensure the state won’t lose billions of dollars’ worth of health and human services funding – a loss that could harm the patients themselves.


Physicians Needed for Medicaid Managed Care Advisory Panel - 03/03/2020

March 13 is the new deadline to get your application to the Texas Health and Human Services Commission if you want to serve on its State Medicaid Managed Care Advisory Committee. The panel advises the commission on Medicaid managed care operations statewide.


Proposed Medicaid Rule Would Severely Restrict Services, Medicine Argues - 02/03/2020

A proposed federal rule that would restrict how states fund their share of Medicaid would cause serious cuts in services, particularly for children, pregnant women, the elderly, and the disabled. That is the message the Texas Medical Association and multiple state and specialty medical societies have delivered to the Centers for Medicare & Medicaid Services.


Federal Funding for Women’s Health Services in Texas Restored - 01/24/2020

Texas will again receive matching federal funds for women’s health services through a Medicaid 1115 waiver Gov. Greg Abbott announced Wednesday. Under the agreement, Texas will receive about $350 million from Washington over the next five years to cover the vast majority of costs for its Healthy Texas Women program.


Help Medicaid Patients Keep Appointments With Free Rides - 12/11/2019

If your Medicaid patient has trouble keeping his or her appointments with your office due to lack of transportation or gas money, be sure the patient knows how to seek help from Medicaid.


Far-Reaching Implications: The Ripple Effects of Texas' Uninsured Rate - 12/04/2019

Data compiled by the Texas Medical Association and other organizations, as well as physicians’ own anecdotal experiences, show how 5 million uninsured patients in Texas become 5 million dominoes. As they fall, so do countless others representing the health of Texas: The economy and well-being of entire communities. The classmates and friends of uninsured children. And yes, the physicians who deal with the burdens of treating uninsured patients in emergency rooms and providing uncompensated care.


Recertification Required for Healthy Texas Women Program - 10/28/2019

If you provide health care services through the Healthy Texas Women (HTW) program, or if you want to begin providing HTW services, the annual recertification period is just around the corner.


Texas Continues to Lead Nation in Uninsured Adults and Kids - 09/30/2019

As of 2018, 11.2% of Texas children younger than 19 were uninsured, up from 10.7% in 2017, according to data the Census Bureau released last week. All told, Texas has led the nation in uninsured residents over the past two years, Census data show.


Tying Immigration to Medicaid Foolish, TMA President Says - 08/20/2019

The Trump Administration's new rule seeking to limit access to green cards for immigrants who receive Medicaid and other government benefits will discourage people from seeing their physicians, worsening medical problems and harming public health, says Texas Medical Association President David C. Fleeger, MD.


Include Physicians on Long-Term Care Facilities Council - 04/09/2019

TMA strongly supports SB 1519 as it will address Texas’ growing need for best practices in dispute resolution and Medicaid quality-based payment systems in long-term care. However, we urge the chair and this committee to consider two additions to the long-term care council that will strengthen its ability to address medical and infectious disease concerns


Strengthen Medicaid MCO Oversight and Improve Access to Care - 04/02/2019

Over the past six months, leaders from TMA, the Texas Hospital Association, Texas Association of Health Plans, and Texas Association of Community Health Plans have met monthly to identify opportunities to reform Medicaid. While we do not always sing Kumbaya, we have developed a better understanding of the root causes of many of problems facing the program. And many problems are much more complex than we first realized, such as simplifying Medicaid prior authorizations.


Children Eligible for Medicaid Need Continuous Coverage - 03/11/2019

Texas is a state that values fairness. In 2007, lawmakers adopted 12 months’ continuous coverage as a best practice for children in CHIP. It is time to provide working parents of children enrolled in Medicaid the same treatment.


Urgent: Action Needed Today To Secure $500 Million For Medicaid - 03/08/2019

On Monday, the House Appropriations Committee will consider amendments, known as “riders,” to its draft state budget for 2020-21. Your state representative serves on the Appropriations Committee. Please contact your representative today and ask him or her to vote to adopt “the Sheffield rider in Article 11” to increase Medicaid rates.


TMA Pushes Back Against Planned Vaccine Payment Cuts - 02/12/2019

As the influenza virus continues to spread statewide, the Texas Medical Association and other specialty societies have taken a stand against a plan to cut by almost 36 percent payments to physicians who administer a flu vaccine in their offices.