New Medicaid/CHIP Guidance on Pharmacy, Medication Policies Available

The Texas Health and Human Services Commission has further updated a frequently asked questions document related to Medicaid and Children’s Health Insurance Program (CHIP) policy changes related to Hurricane Harvey.

The updates, dated Sept. 18, focus on pharmacy and medication as well as STAR+PLUS services: 

  • “Will managed care organizations be able to submit pharmacy encounters for claims paid to out of state pharmacies?
  • Will VDP extend the available drugs beyond the Centers for Medicare & Medicaid Services approved list?
  • What is the STAR+PLUS MCO’s process for transitioning individuals receiving private duty nursing to STAR+PLUS at age 21 who have not been assessed for STAR+PLUS Home and Community Based Services or inclusion of nursing in their Intellectual and Developmental Disability waiver?”

The document, which has been updated regularly since it was first published in the days after the storm made landfall Aug. 25, provides information and guidance on a variety of issues, including: 

  • Federal waivers and modifications,
  • Fair hearings,
  • CHIP cost-sharing,
  • Social Security,
  • Out-of-state providers,
  • Prescriptions, and 
  • Benefits.

More information on Hurricane Harvey can be found at TMA’s Disaster Preparedness and Response Resource Center.

TMA’s Disaster Relief Program has received nearly $1 million to help physicians with uncompensated damage to their medical practice caused by Hurricane Harvey. TMA’s philanthropic arm, TMA Foundation, is overseeing fundraising, and The Physicians Benevolent Fund is administering the TMA Disaster Relief Program. To apply for funds through The Physicians Benevolent Fund, email disaster[at]texmed[dot]org.

Last Updated On

September 19, 2017

Originally Published On

September 19, 2017