Provider News
Third Party Liability – Medicaid Managed Care Provider Requirements
Texas Health and Human Services Commission (HHSC) and Office of Inspector General-Third Party Recoveries division (OIG-TPR) has recently seen a high number of escalations due to Providers refusing to see a Medicaid eligible Member because the Member has other health...
HHSC to Reduce Use of Alternative Devices for EVV-Required Services
To enhance program integrity, HHSC is reducing the use of alternative devices as an approved method of clocking in and clocking out for EVV-required services. The phased reduction will begin September 1, 2025, and complete on September 1, 2028. By September 1, 2028,...
Provider Guidance: Pertussis (Whooping Cough)
Adapted from: Symptoms of Whooping Cough | Pertussis (Whooping Cough) | CDC Early treatment and prophylaxis can make illness less serious and prevent the spread of infection. Treatment of infection and prophylaxis for all asymptomatic household contacts is recommended...
Payspan Portal Production Maintenance – Saturday, October 26, 7:30 p.m. (ET) through Sunday, October 27, 9:30 a.m. (ET)
Zelis® is utilizing a maintenance window for the Payspan Portal on Saturday, October 26, 7:30 p.m. (ET) through Sunday, October 27, 9:30 a.m. (ET). The following System Availability chart notes affected services.
EVV Usage Reviews Starting January 1, 2025
Effective January 1, 2025, Community First Health Plans, Inc. and HHSC will conduct EVV usage reviews to ensure that Personal Care Services (PCS) and Home Health Care Services (HHCS) meet state-mandated EVV requirements. This includes the potential for contract...
Coverage of the HPV Vaccine and ASN Updates
This notice is to clarify coverage of the human papillomavirus (HPV) vaccine, also referred to as Gardasil, and how reimbursement for the vaccine may be impacted by changes to the vaccines covered by the Adult Safety Net (ASN) Program. The ASN program is administered...