New Guidance on Medicaid Prior Authorizations Related to Harvey Issued

The Texas Health and Human Services Commission (HHSC) has released new information and guidance on Medicaid prior authorizations as well as temporary electronic visit verification policies for physicians and other health care providers affected by Hurricane Harvey.

In a lengthy Q&A that has been updated since the hurricane made landfall Aug. 25, HHSC reiterated that managed care organizations (MCOs) in Federal Emergency Management Agency (FEMA) declared disaster areas can extend prior authorizations that expired Aug. 25 for up to 90 days from when the emergency disaster proclamation expires.

In addition, HHSC has announced that MCOs and the Texas Medicaid and Healthcare Partnership will be allowed to “waive currently required provider documentation, MCO and HHSC review criteria, required consultation requirements for authorization, review and documentation requirements of the state plan, contract or limitation of services.”

Additional frequently asked questions answered in the Q&A include: 

  • Can I complete visit maintenance if it is past the 60-day visit maintenance timeframe?
  • Can I bill a claim before completing visit maintenance?
  • If the landline or the small alternative device is not working, can my attendants use their personal cell phone if they are providing services?
  • What reason code do I use if I am affected by Hurricane/Tropical Storm Harvey?
  • Will nursing facilities continue to get paid for their Medicaid residents whose eligibility ends during the disaster?

In addition, the Disaster Supplemental Nutrition Assistance Program, commonly known as D-SNAP, will be extended to residents in Aransas, Brazoria, Calhoun, Nueces, Polk, Refugio and San Patricio counties, in addition to the 11 initial counties previously announced, officials said. Residents in those counties will be able to use the program, which provides short-term food benefits for eligible families recovering from a disaster, starting Sept. 18 or 19.

More information on Hurricane Harvey recovery can be found in TMA's Disaster Preparedness & Response Resource Center or by contacting the TMA Knowledge Center at knowledge[at]texmed[dot]org or (800) 880-7955 or (512) 370-1544.

Physicians who want to help their colleagues rebuild their practices damaged by Harvey can make a tax-deductible donation to the TMA Disaster Relief Program. Funds from the program will help physicians pay for storm loss expenses their insurance or other sources will not cover. The goal is to raise more than $1 million. 


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Last Updated On

September 18, 2017