Medicaid and CHIP

  • Texas Medicaid, CHIP Changes Extended Into January

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    Some Medicaid and Children’s Health Insurance Program (CHIP) flexibilities put in place during the COVID-19 pandemic have been extended into January, state health officials announced.

    Learn More About the Extension  
  • Which Plans Pay for Telemedicine Services – and for How Long?

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    As you’re no doubt aware, telemedicine has made it possible for many physicians to continue seeing patients while reducing the risk of spread during the COVID-19 pandemic.

    Temporary changes to state and federal rules, particularly regarding payment for services, have helped push up the new demand for and use of telemedicine. 

    Find Out What Each Type of Plan Pays for Telemedicine Services  
  • How Health Plans Are Covering COVID-19 Testing and Treatment

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    Many health insurers in Texas are waiving patient costs associated with COVID-19. Last week in a news release, Gov. Greg Abbott and the Texas Department of Insurance asked insurers and HMOs to cover testing consistent with Centers for Disease Control and Prevention guidance, and telemedicine visits.

    COVID-19 and Health Plans: What's Covered?  
  • Payer Policies for Telemedicine Services


    In the wake of COVID-19, TMA is getting calls about which payers are covering telemedicine. TMA developed this quick reference guide to help you navigate telemedicine reimbursement. This table now reflects Medicare’s waiver of the geographic and place of service restrictions for Medicare (which means patients can now be at home).

    Additionally, the Governor directed TDI to issue an emergency rule related to the payment of telemedicine to allow state-regulated plans (about 20% of the commercial market in Texas) to allow telephone and telemedicine visits to be paid at the same rate as in-office visits. If you are not sure which patients are regulated by TDI, check this guide.  Stay tuned for more detail.

    Updated July 27, 2020

    View the Chart  
  • Feds Approve Texas’ Request for COVID-19 Medicaid Waiver

    COVID-19 Medicaid Waiver  

    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.

    Learn About the Medicaid 1135 Waiver  
  • A Case for More Coverage: Studies Suggest Medicaid Expansion Would Fiscally Benefit Texas

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    Two recent studies suggest expanding Medicaid will not only save Texas money, but add to the Lone Star State’s coffers.
    With another opportunity for the Texas Legislature to debate Medicaid expansion on the horizon, the Texas Medical Association sees the Episcopal Health Foundation reports as evidence to support efforts to expand meaningful coverage for the state’s poor and vulnerable populations.

    Learn More  
  • Medicine Pushes Texas Medicaid to Help Save Primary Care


    Leaders of the Texas Medical Association and four large primary care specialty societies on Wednesday painted for senior Medicaid officials the bleak fiscal picture of many physician practices, and requested immediate financial assistance.

    Read the Wish List  
  • Federal Funding for Women’s Health Services in Texas Restored

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    Texas will again receive matching federal funds for women’s health services through a Medicaid 1115 waiver Gov. Greg Abbott announced Wednesday.

    More About the Agreement  
  • Medicine Pushes For Expanding Medicaid Coverage to New Moms

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    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.

    Give New Mothers
    a Fighting Chance
  • Healthy Vision 2025 Provides Medicaid, Uninsured Fixes

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    The combination of the country’s highest uninsured rate and a stressed Medicaid program threaten not only the health of millions of Texans, but also the health of the economy, Texas Medical Association President Doug Curran, MD, says.

    Make It Easier for Every Texan to See a Doctor  
  • TMA Testimony: Medicaid

    Moms and Babies Need Comprehensive Health Care Coverage 
    (Written Comments on Interim Charge 1, House Public Health Committee, Oct. 16, 2020)

     Let's Work Together to Strengthen Rural Health
    (Written Comments on Interim Charge 1, House Committee on Public Health, Oct. 16, 2020)

    Renew and Strengthen Texas' Medicaid 1115 Waivers  
    (Written Comments on Interim Charge 2, Article II: Review how Texas is preparing for state and federal budgetary changes that impact the state's health programs, including: the Family First Prevention Services Act; the next phase of the 1115 Healthcare Transformation and Quality Improvement Program Waiver; Texas’ Targeted Opioid Response Grant; the Centers for Medicare and Medicaid Services proposed Medicaid Fiscal Accountability rule, and the Healthy Texas Women Section 1115 Demonstration Waiver. Interim - Sept. 30, 2020)

    Support Early Childhood Brain Development with an Enhanced ECI Program
    (Written comments on the Charge No. 5 request for information: Examine state investments in the health and brain development of babies and toddlers, including Early Childhood Intervention and other early childhood programs for children in the first three years. Evaluate opportunities to boost child outcomes and achieve longer-term savings today on the vital importance of the ECI program for some of Texas’ most at-risk and vulnerable infants and toddlers. A Child’s. Interim - Sept. 30, 2020)

    Make Medicaid Managed Care More Efficient
    (Testimony on House Bill 4178 by Doug Curran, MD, April 9, 2019)

    Read more TMA Medicaid testimonies.


    TMA is helping to strengthen your practice by offering advice and creating a climate of medical success across the state. 

  • What could a TMA membership mean for you, your practice, and your patients?