Jul 23, 2025 | Provider News
The National Committee for Quality Assurance (NCQA) has implemented key changes to the HEDIS Follow-Up After Hospitalization for Mental Illness (FUH) measure. These updates expand Provider and service eligibility, making it easier to meet the measure and support...
Jul 18, 2025 | Provider News
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...
Jul 17, 2025 | Provider News
On June 27, 2025, the Centers for Medicare & Medicaid Services (CMS) approved a five-year extension of Texas Health and Human Services Commission (HHSC) Healthy Texas Women (HTW) Section 1115 Medicaid demonstration. The demonstration is effective July 1, 2025,...
Jul 17, 2025 | PEMS, Provider News
Beginning July 8, providers who have already received a 180-calendar day extension for their provider enrollment revalidation due date will be eligible for a second 180-calendar day extension if they do not complete revalidation by their revised due date. This will...
Jul 17, 2025 | PEMS, Provider News
The Texas Drug Utilization Review Board agenda for Friday, July 25, 2025, is now available. Refer to the Texas Drug Utilization Review Board Handbook for instructions on submitting written materials to the board before the meeting and public testifying on the day of...
Jul 17, 2025 | Provider News
On Friday, July 4, 2025, severe flooding impacted communities in the Texas Hill Country. The Vendor Drug Program provided pharmacy claims guidance related to refill too soon rejections. Pharmacies may contact the Texas Medicaid Pharmacy and Technical Call Center at...
