Medicaid Matters

Here's what's happening in the Texas Medicaid program this month:

Do Ask, Do Tell
State officials want to know what physicians think about their experiences with pediatric specialty and subspecialty consultations and referrals so they can understand their problems. The effort is part of the state's initiative to improve access to specialty and subspecialty care for the pediatric Medicaid population.

There are two surveys. One is for primary care physicians , the other for pediatric subspecialists .

Each survey should take less than 15 minutes to complete. Have your medical license number available.

Please complete the survey no later than May 30. Physician participation is essential in helping the state develop possible solutions to the barriers faced in treating children in Medicaid.

Physicians selected to participate in the program will be reimbursed for their time.

Funds for Treating Hurricane Evacuees Available
The U.S. Department of Health and Human Services has given the state a special Social Services Block Grant [ PDF ] that can be used, in part, to process physicians' claims for treating uninsured Hurricane Ike and Hurricane Dolly evacuees who are not eligible for Medicaid.

Such claims are exempt from prior authorization and 95-day filing deadline requirements.

Funds for uninsured evacuees of Hurricane Dolly and Hurricane Ike are limited, and claims will be paid only until the funds are exhausted. Physicians are encouraged to file claims as soon as possible.


Pediatric Consultants Wanted
The Texas Health and Human Services Commission seeks board-certified pediatric specialists to provide consultation services to its medical director's office and the Texas Medicaid & Healthcare Partnership medical staff. The consultations involve phone calls concerning pediatric medical policy. 

Instructions for applying and an agreement detailing your rights, reimbursement, and obligations as an independent consultant are posted online. 

Oral Health Webinars Scheduled
Webinars to help physicians qualify to join Texas Medicaid program's new fluoride varnish program will be May 5 and May 19. Physicians and other health care professionals must have state certification to participate in the program.

Medicaid pays primary care physicians, physician assistants, and advanced practice nurses for a limited oral health evaluation and application of fluoride varnish for children aged between 6 months and 35 months as part of a Texas Health Steps (THSteps) medical visit. The reimbursement is $34.16 and is in addition to the THSteps medical checkup payment.

The program resulted from the settlement of the Frew v. Hawkins lawsuit over services to Medicaid patients.  


Action , May 4, 2009