Forgot password

Not a Member?
JOIN TODAY

HIV and Enteropathy
Advertisement
Texas Medicaid Expansion
Medicaid Expansion:
Texas does not participate in Medicaid Expansion under provisions of the Affordable Care Act (ACA).
For additional background on the State’s policy decisions regarding the Medicaid Expansion option, see: Background.
 
Medicaid in Texas:
The Texas Health and Human Services Commission administers the Medicaid Program.

Information about the state’s Medicaid program, including patient eligibility information, can be found at: http://www.hhsc.state.tx.us/.
Provider Participation:
Providers must enroll in the Medicaid fee-for-service program to receive payments for covered services. Information about enrolling in the Medicaid fee-for-service program can be found at: http://www.tmhp.com/Pages/ProviderEnrollment/PE_TX_Medicaid_New.aspx.
The Medicaid website provides information about services covered by fee-for-service payments and payment amounts: http://www.hhsc.state.tx.us/.
In order to retain access to all Medicaid patients in the state, providers must also connect to the managed care plans individually.
 
Medicaid Managed Care:
Some Texas Medicaid Program beneficiaries are enrolled in managed care plans, called STAR.
Basic information about STAR can be found at: http://www.tmhp.com/Pages/Medicaid/Medicaid_Managed_Care.aspx.
Some managed care plans cover individual Texas counties and independent cities. The Medicaid website has jurisdictional information: http://www.tmhp.com/Pages/Medicaid/Medicaid_Managed_Care.aspx.
STAR Beneficiaries Participating in Managed Care:
Managed care plans participating in STAR offer detailed information about covered benefits for individuals enrolling in their plans. This information is available on the managed care websites shown below.
Reporting Problems

The state Medicaid office is primarily responsible for examining and addressing issues with the Medicaid Managed Care plans offered in the state, and for working with the companies that offer them. If you are experiencing problems as a medical provider with the Managed Care plans or companies operating in the state, or if your patients are experiencing problems with the Managed Care plans or companies in the state, including trouble with access to medications, access to preferred providers, navigating the appeals process, excessive costs, or possible discriminatory policies, or any other problems related to the Affordable Care Act, please report these problems to the state Medicaid Office:

http://www.hhsc.state.tx.us/Medicaid/

888-834-7406

Additionally, if you are experiencing these or other problems, please report these problems to AAHIVM, so that we may track issues affecting our members, and seek additional policies remedies.

Managed Care Plans Participating in STAR:
Aetna Better Health
 
Amerigroup TX
 
Blue Cross and Blue Shield of TX
 
Christus Health Plan
 
Community First Health Plan
Provider Enrollment: http://www.cfhp.com/providers/
 
Community First Health Plan
Plan Website: http://www.cfhp.com/
 
Cook Children's Health Plan
 
Driscoll Children's Health Plan
 
El Paso First CHIP
 
El Paso First Premier Plan
 
FirstCare STAR
 
HealthSpring
 
Parkland HealthFirst
 
Right Care Scott and White Health Plans
 
Sendero Health Plans
 
Seton Health Plan
 
STAR Health Children's Protective Services
 
Supervisor HealthPlan
 
TX Children's Health Plan
 
United Healthcare Community Plan
 
Bookmark and Share