Provider News
Healthy Texas Women Medicaid 1115 Demonstration Waiver Extended through June 30, 2030
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,...
Second Provider Enrollment Revalidation Due Date Extension Begins July 8
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...
Agenda for April Drug Utilization Review Board Meeting Now Available
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...
UPDATED: Pharmacy Claim Guidance Following Texas Hill Country Flooding
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...
Semi-annual Medicaid Preferred Drug List Update Scheduled for July 28, 2025
HHSC will publish the semi‑annual update to the Texas Medicaid Preferred Drug List (PDL) on July 28, 2025. These changes are based on recommendations from the January 2025 and April 2025 Texas Drug Utilization Review (DUR) Board meetings. The updated PDL and PDL...
Payspan Portal Production Maintenance – Saturday, July 19, 8:00 P.M. (ET) through Sunday, July 20, 9:00 A.M. (ET)
Zelis® is utilizing a maintenance window for the Payspan Portal on Saturday, July 19, 8 P.M. (ET) through Sunday, July 20, 9 A.M. (ET). Note: If the maintenance activities are completed before 9 A.M. (ET), we will end the maintenance early. The following System...
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