UPDATED 9/3/2025: This news post has been edited to reflect updated guidance from HHSC. The information below applies to all Texas Medicaid clients impacted by the 2025 Texas flooding regardless of whether the clients are permanent residents of a declared disaster county. This guidance is effective from July 2, 2025, through Sept. 29, 2025.
Effective July 2, 2025, through September 29, 2025, the Texas Medicaid & Healthcare Partnership (TMHP) is expediting the processing of new prior authorization requests and recertifications for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) that were lost or damaged because of the Central Texas floods.
This updated guidance now applies to all Texas Medicaid clients impacted by the 2025 Texas flooding, regardless of whether the client is a permanent resident of a declared disaster county.
TMHP is waving normal submission timeframes and documentation requirements for these replacement requests.
When submitting a prior authorization, Providers must:
- Clearly state that the request is related to the Central Texas floods.
- Include an explanation of why the equipment needs to be replaced.
Important:
This policy is in effect from July 2, 2025, through September 29, 2025. It applies to Providers serving Texas Medicaid clients.
Providers must keep documentation showing that the DMEPOS items were lost, destroyed, irreparably damaged, or otherwise unusable due to flooding. Services provided may be subject to retrospective review for medical necessity.
For more information, contact:
- TMHP Contact Center: 800‑925‑9126
- TMHP‑CSHCN Services Program Contact Center: 800‑568‑2413
Providers are encouraged to share this information with their staff. If you have any questions about this notice, please email Provider Relations at ProviderRelations@cfhp.com or call 210-358-6030. You can also contact your Provider Relations Representative directly.
To access all Provider alerts:
- Log into the Community First Provider Portal
- Go to CommunityFirstHealthPlans.com/Provider-News
- Sign up for the Community First Provider eNewsletter