Category: Medicaid
UHC April Monthly Overview
For Texas:
Starting June 1, 2023, Optum will manage prior authorization and step therapy requests for prescription medications for Texas residents with pharmacy coverage.
CHIP Co-Pay Resumes
At the end of the PHE, May 11, 2023
Superior announcing the CHIP Co-Pay will resume.
Superior Risk Adjustment Training
Superior will be hosting a series of webinars to assist providers with Risk Adjustment Documentation and Coding. All levels of clinicians and billing and coding staff are encouraged to attend.
UHC Relief At Last!!
Finally, Some United HealthCare Relief!
As of this morning POET has acquired a list from UHC regarding the products for our Agreement.
If you are having issues with any par plans on this list. Please email a copy of the card and patients date of birth to [email protected]. Include a brief description of the issue.
Remember this information is confidential and pertains only to the POET Agreement.
TX Resources for Family
Physicians who frequently refer patients to no- and low-cost state services like health insurance and child care will find that easier now that the state has launched familyresources.texas.gov, a website that puts links to those services all in one place.
UHC Policy Updates for March 2022
Just click the button to check out the latest from UHC.
Superior Prior Auth Requirements
Superior will be ending any active prior authorizations for Synagis® effective February 1, 2022 for all Superior Medicaid (STAR, STAR Health, STAR Kids, STAR+PLUS) and CHIP members to align with HHS guidance. As the season has ended, claims for Synagis® will no longer adjudicate pursuant to the end of the season per VDP guidance.
Superior HealthPlan will require prior authorization for CPT code 81519, Oncology Breast MRNA, for Medicaid, CHIP and Superior HealthPlan Medicare-Medicaid Plan (MMP) members. Superior HealthPlan will utilize Change Healthcare’s InterQual as the medical necessity review criteria. Effective on May 1, 2022
You have to revalidate your enrollment to stay in Medicaid.
If you are a physician participating in the Texas Medicaid program and saw your required revalidation period for the program extended due to the COVID-19 pandemic, take note:
The End Of That Extension Is Coming on February 28th, 2022.
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