Category: Medicaid
Md and CHIP Patients Required to Verify!
Medicaid and CHIP patients are required to verify their eligibility EVERY YEAR or risk losing it.
Coming Soon: PEMS
Coming Soon: TMHP Provider Enrollment and Management System (PEMS)
Providers should plan for the following changes on December 13, 2021:
- PEMS will replace Provider Enrollment on the Portal (PEP) and the Provider Information Management System (PIMS).
- PEP and PIMS will no longer be available.
- Paper applications for Texas Medicaid provider enrollment will be eliminated with the new online system.
- Providers must have access to the internet to utilize PEMS and use up-to-date internet browsers for optimum performance of the PEMS portal. Use Google Chrome or Microsoft Edge to reduce compatibility issues
When the PHE Expires, What then?
How to Reverify Patients’ Medicaid Eligibility
When the Public Health Emergency Ends
With the federal public health emergency (PHE) slated to expire at the end of 2021, millions of Medicaid patients across the U.S. are at risk of losing their coverage. Texas physicians should prepare by scheduling services as soon as possible for such patients and evaluating the financial impact of potential increases in uncompensated care. They also should expect to reverify patients’ Medicaid eligibility when the PHE expires.
Physicians can reverify patients’ eligibility electronically through the Texas Medicaid & Healthcare Partnership (TMHP) Electronic Data Interchange, TexMedConnect, or the Medicaid Client Portal. They can also call the TMHP Automated Inquiry System at (800) 925-9126.
Prior Auth Changes, Superior
Prior Authorization Changes,
Effective September 1, 2021
New Codes Requiring Auths:
- 33270
- 33271
- 33274
Prior Auths Removed:
- 33273
- 93287
- 93290
Medicare Learning Network (MLN) Learning Management System (LMS) FAQs 8/2019
The Medicare Learning Network® (MLN) offers free educational materials for health care professionals on Centers for Medicare & Medicaid Services (CMS) programs, policies, and initiatives. Find a complete list of MLN educational offerings in the MLN Catalog at http://go.cms.gov/mln-catalog.
For a complete “HOW TO” guide on the MLN and LMS System, including how to set up an account: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/LMPOS-FAQs-Booklet-ICN909182.pdf
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