Feb 14, 2025 | Member News
Members of Community First STAR, STAR Kids, STAR+PLUS plans who are receiving or are prescribed treatment for behavioral health or substance use disorders, have the right to receive medically necessary in lieu of services (ILOS). You also have the right to decline...
Feb 14, 2025 | HHSC News, Provider News
In Lieu of Services (ILOS) are services that have been approved by Texas Health & Human Services Commission (HHSC) to be medically appropriate, clinically appropriate, and cost-effective substitutes for covered services under Texas Medicaid. Texas Medicaid...
Feb 11, 2025 | Provider News, Provider Resource
The January 2025 Medicaid Preferred Drug List (PDL) is now available. This latest update includes significant changes approved during the July and October 2024 Drug Utilization Review Board meetings. These updates impact formulary details, prior authorization...
Feb 10, 2025 | Provider News
Zelis® is utilizing a maintenance window for the Payspan Portal on Saturday February 15, 5:00 P.M. (ET) through Sunday, February 16, 8:00 A.M. (ET). Note: If the maintenance activities are completed before 8:00 A.M. (ET), we will end the maintenance early. The...
Feb 6, 2025 | PEMS, Provider News
Community First Health Plans reminds all pharmacy Providers that the Texas Health and Human Services Commission (HHSC) manages pharmacy enrollment operations through the Provider Enrollment and Management System (PEMS). PEMS serves as the single platform for...
