Feds Approve Texas’ Request for COVID-19 Medicaid Waiver

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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.

The Medicaid 1135 Waiver will allow the state to extend Medicaid fee-for-service and managed care prior authorizations that expire within the next 30 days without further action from physicians or providers. The waiver also will extend Medicaid revalidation timeframes, and establish expedited enrollment for physicians not currently enrolled in Medicaid.

The Texas Health and Human Services Commission (HHSC) also announced additional measures to help physicians and families, including:

  • Allowing payment for telephone (audio only) calls for services provided within Medicaid, Medicaid managed care, and the Healthy Texas Women program;
  • Allowing payment for telephone (audio only) calls for certain behavioral health services, including psychiatric diagnosis; and
  • Waiving office copayments for children enrolled in the Children’s Health Insurance Program (CHIP).

The new flexibilities will be in effect through April 30, 2020, with the possibility of an extension.

Additionally, HHSC announced on March 28 it will automatically extend renewals for people enrolled in Medicaid. The federal Families First Coronavirus Prevention Act (FFCPA), signed into law March 18, included provisions to help families maintain Medicaid and nutrition assistance throughout the emergency. Per the new law, the federal government will increase its share of Medicaid costs by 6.2% in exchange for states maintaining Medicaid coverage for people enrolled on or after March 18, 2020, and through the emergency declaration.

FFCPA did not require states to maintain coverage for children enrolled in CHIP; however, HHSC has indicated it has requested authority from CMS to apply the same policy within that program.

In addition, renewals for the Supplemental Nutrition Assistance Program (SNAP) also will be extended automatically until further notice, and the state will waive in-person interview requirements for families to enroll in SNAP.

FFCPA also contained other important Medicaid and CHIP provisions, including:

  • Requiring states to cover COVID-19 testing, services, and treatment, including vaccines, without cost-sharing for Medicaid enrollees.
  • Establishing a new optional Medicaid eligibility category to pay for COVID-19 testing (not treatment), with 100% federal funding; and
  • Providing $1 billion in federal funding to the National Disaster Medical System to pay the cost of testing for the uninsured who do not qualify for Medicaid.

Find the latest news, resources, and government guidance on the coronavirus outbreak by visiting TMA’s COVID-19 Resource Center regularly.

Last Updated On

March 31, 2020

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