Provider News
EVV Impacts Due to Dual Integration Project, Phase II Effective January 1, 2027
Community First Health Plans is sharing important information from the Texas Health and Human Services Commission (HHSC) regarding Electronic Visit Verification (EVV) impacts related to Phase II of the Integrated Dual Eligible Special Needs Plan (Integrated D-SNP)...
How to Handle Appeals for Recoupments Due to HHSC Retroactive Eligibility Changes
Member eligibility changed from one Managed Care Organization (MCO) to another on the date of service.Providers may appeal claims payment recoupments and denials of services by submitting the following information to the appropriate MCO to which the Member eligibility...
Medicare Annual Enrollment Period Is Here – Review Important Changes for Dual Eligible Members
The Medicare Annual Enrollment Period (AEP) runs from October 15 through December 7. During this time, eligible Medicare beneficiaries can review their coverage options and select a new health plan for 2027.Providers may receive questions from patients about their...
IMPORTANT: Register for October 21 Provider Webinar on Integrated D-SNP Model Changes
The Texas Health and Human Services Commission (HHSC) is hosting a webinar to help Providers prepare for the 2027 Integrated D-SNP model changes. DATE: Wednesday, October 21, 2026 TIME: 12 p.m. to 1 p.m. REGISTER NOW: Texas Integrated Dual Eligible Special Needs...
Annual EVV Policy Training Webinar Registration Now Open
Community First Health Plans is sharing information about upcoming Texas Health and Human Services Commission (HHSC) Annual Electronic Visit Verification (EVV) Policy Training Webinars for Program Providers, Financial Management Services Agencies (FMSAs), and Consumer...
Cranial Remolding Orthosis Benefit Update and TMHP Provider Training Available
Effective September 1, 2026, Texas Medicaid updated benefit criteria for cranial remolding orthoses (CRO), procedure code S1040, in accordance with House Bill 426 from the 89th Texas Legislature. The updated criteria expand coverage for certain non-synostotic...
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