Medicaid and CHIP advocacy

Check For 2019 MIPS Errors, File Targeted Review Today - 10/05/2020

If you haven’t already done so, now is the time to check your Merit-Based Incentive Payment System (MIPS) performance feedback, including your 2019 MIPS final score and 2021 payment adjustment, and file a targeted review by Oct. 5, if needed.

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.

TMA to State: Protect Physician Pay, Women’s Health Programs from Budget Cuts - 06/04/2020

The Texas Medical Association is applauding state leaders’ decision to leave Medicaid and CHIP benefits out of a planned 5% budget reduction for 2020-21. But TMA also is asking the state to protect physicians’ Medicaid payments and women’s health programs from its cuts.

Extend Medicaid Changes Throughout, After Emergency, Medicine Tells State - 05/21/2020

Changes to Medicaid put in place during the COVID-19 pandemic should be extended to ensure physicians can continue to provide care for Texas’ children and youth. That is the message the Texas Medical Association and several specialty societies sent in a letter this week to the Texas Health and Human Services Commission’s  director of Medicaid and CHIP Services.

Medicine Pushes For Expanding Medicaid Coverage to New Moms - 12/19/2019

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.

Feb. 27 Hotline: Physicians Urge State to Put $500 Million More Into Medicaid - 02/27/2019

Yesterday, the Texas Medical Association urged state budget writers to invest $500 million of general revenue in Medicaid to improve access to care in Texas.

Panel: Value-Based Care Bearing Fruit - 01/30/2019

Although some of the numbers documenting access to care in Texas are less than encouraging, the shift to value-based care in Medicaid is showing positive signs, a panel collectively told the Texas Medical Association’s Winter Conference on Saturday at the Hyatt Regency Austin.

Pediatrician Named HHSC Medicaid Chief Medical Officer - 01/15/2019

San Antonio pediatrician Ryan Van Ramshorst, MD, has been appointed chief medical officer for Medicaid and the Children's Health Insurance Program within the Texas Health and Human Services Commission.

Congress Puts CHIP Back on Course - 01/23/2018

The news was almost lost amid the furor over the government shutdown and immigration politics. But it did happen. Funding for CHIP was extended for six more years on Monday.

CHIP Rings In a New Year – Sort Of - 01/19/2018

According to a recent survey by the T.H. Chan School of Public Health at Harvard University, renewing funding for the Children’s Health Insurance Program (CHIP) is the public’s top priority for Congress. Yet here we are, three months past its expiration, with no resolution in sight despite a fresh new year full of promise and hope.

TMA to Congress: Renew Health Coverage Funding for 400,000 Texas Children - 10/17/2017

Although Texas officials are optimistic that federal funding for the Children’s Health Insurance Program (CHIP) will be renewed, TMA is leading the Coalition of State Medical Societies’ efforts in urging federal lawmakers to support the program through 2019 and beyond.

TMA, THA Leaders Push Senator Cornyn on Proposed Medicaid Changes - 07/06/2017

Leaders of the Texas Medical Association and the Texas Hospital Association met with U.S. Sen. John Cornyn on July 3 to work out a better solution for the Medicaid provisions in the Better Care Reconciliation Act (BCRA), the Senate’s bill to repeal and replace the Affordable Care Act.

Maintain Medicaid Children’s Continuity of Care - 03/14/2017

Currently, children in Texas Medicaid only have continuous periods of eligible coverage for six months at a time unlike most plans offered in the Children’s Health Insurance Program and the commercial insurance setting. As a pediatrician who cares for children in Medicaid every day, I know the value this coverage brings them. In fact, the value of Medicaid grows exponentially the longer a child has continuous coverage. As their primary care physician, I am able to maintain a relationship with the family providing needed anticipatory guidance to prevent unnecessary injuries. I can manage a child’s complex condition — physical or mental — to ensure they remain productive in school and healthy into adulthood. Continuity of care can be jeopardized if the child churns on and off Medicaid for any reason.

TMA's Medicaid Recommendations Can Improve Care, Reduce Costs - 01/10/2017

As state lawmakers begin preparing for the 2017 legislative session, TMA and four state specialty societies delivered a detailed, five-page document with significant recommendations to improve the Texas Medicaid program.

How Will Your Practice Thrive in Post-SGR Medicare? - 12/09/2016

The Sustainable Growth Rate (SGR) is gone, so now what's next? Is your practice ready for quality-based payment? Is that even the right direction for you to go? With the Medicare Access and CHIP Reauthorization Act of 2015 taking effect and the Merit-Based Incentive Payment System on the horizon, making no changes may cost you, but implementing changes (the wrong way) may cost you more.

TMA Asks HHSC to Request More Medicaid, Public Health Funds - 10/11/2016

It's that time in the state's two-year budget cycle when state agencies prepare funding requests for the Texas Legislature to consider in next year's session. No agency's budget is more important to physicians than that of the Texas Health and Human Services Commission (HHSC), whose massive portfolio includes the state's Medicaid, public health, mental health, and women's health programs.

HHSC Offers STAR Kids Webinar for Physicians - 10/11/2016

If you participate in Medicaid, don't forget about the STAR Kids managed care program coming Nov. 1. The legislature directed the Texas Health and Human Services Commission (HHSC) to develop the managed care program specifically designed for children aged 20 years and younger who have disabilities.

Improve LARC Access With New Toolkit - 10/10/2016

You can help make long-acting reversible contraceptives (LARCs) available to all Texas women with the help of a new toolkit developed by the Texas Health and Human Services Commission in conjunction with the Texas Department of State Health Services and the Texas chapter of the American College of Obstetricians and Gynecologist. LARCs provide a highly effective contraceptive option with high rates of patient satisfaction and continued use. Improving access to LARCs is a TMA priority.

STAR Kids Takes Effect Nov. 1; Training Available - 10/10/2016

If you participate in Medicaid, don't forget about the implementation of the STAR Kids managed care program on Nov. 1. The legislature directed the Texas Health and Human Services Commission (HHSC) to develop the managed care program specifically designed for children aged 20 and younger who have disabilities.

Medicaid Transformation Waiver Extension Request Due Sept. 30 - 05/13/2016

Texas’s five-year 1115 Medicaid Transformation Waiver will expire Sept. 30, 2016. To extend or renew the waiver, the Texas Health and Human Services Commission (HHSC) has to submit a request to the Centers for Medicaid and Medicare Services (CMS) by Sept. 30, 2015.

Medicaid Restores Payment Levels for Child Vision Services - 05/13/2016

Medicaid is restoring physician payments for 50 pediatric eye codes to higher levels paid prior to July 1, 2015. The increase, which takes effect April 1, averages 6.6 percent across all codes.

Medicaid Not Jumping at TMA’s 1115 Waiver Ideas - 05/13/2016

State Medicaid officials offered a lukewarm response to TMA's recommendations to increase physician involvement in Medicaid transformation plans, boost physicians’ Medicaid payment rates, and design a privately-based plan to cover more uninsured, low-income Texas adults.

Makena Added to Medicaid, CHIP Formulary Starting June 15 - 05/13/2016

Starting June 15, Makena, the brand name version of 17P or hydroxyprogesterone caproate, will be on the Texas Health and Human Services Commission (HHSC)  Medicaid and Children's Health Insurance Program formulary. Makena will be available in a 120 mg/5 mL dosage as both a medical and pharmacy benefit. HHSC's Vendor Drug Program implemented Makena as a Medicaid pharmacy benefit in an effort to help reduce preterm births by expanding access to the drug.

HHSC Launches Policy Feedback Webpage - 05/13/2016

The Texas Health and Human Services Commission (HHSC) has a new webpage that features a list of proposed Medicaid policy changes. Via the webpage, physicians and other medical practitioners, program clients, and the general public can give HHSC direct feedback regarding new medical and dental policies or changes to existing policies.

CMS Extends Texas' 1115 Medicaid Waiver by 15 Months - 05/13/2016

The Texas Health and Human Services Commission (HHSC) has reached an agreement with the Centers for Medicare & Medicaid Services (CMS) on a 15-month extension of the state's 1115 Medicaid waiver. The waiver funds uncompensated care and the Delivery System Reform Incentive Payment Program (DSRIP) through December 2017 and will maintain its current funding. While physicians applaud the move, they say it doesn't alleviate their concerns about a long-term solution to sustain funding for uncompensated care.