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Important Update Actualización importante:

Good news! All CHIP, STAR, and STAR Kids Member Handbooks are now available online. Quick, easy access to your benefits and coverage information - any time!

¡Buenas noticias! Todos los manuales para miembros de CHIP, STAR y STAR Kids ya están disponibles en línea. Obtén acceso rápido y sencillo a la información sobre tus beneficios y cobertura, ¡en cualquier momento!

Medicaid Preferred Drug List and Formulary Changes Cambios en el formulario y la lista de medicamentos preferidos de Medicaid

The Vendor Drug Program (VDP) made changes to the Texas Medicaid drug formulary effective July 24, 2026. To learn more about formulary changes impacted, please click here for more information.

El programa de medicamentos de proveedores de Texas (VDP) ha realizado cambios recientes en el formulario de medicamentos de Medicaid de Texas. Esto entrará en vigencia el 24 de julio de 2026. Para obtener más información sobre los cambios en el formulario afectados, visite el siguiente enlace para obtener más información.

TexMedConnect and EVV Portal Access

Date: July 25, 2023

Attention: Home Health Care Services Providers, STAR Kids Providers/Consumer Directed Services employers and FMSA Providers

Effective Date: January 1, 2024

Call to action:

The Texas Health and Human Services Commission (HHSC) would like to let providers know that Electronic Visit Verification (EVV) will be required for Home Health Care Services (HHCS) as of January 1, 2024.

The HHCS required to use EVV are found in the document, Programs, Services and Service Delivery Options Required to Use Electronic Visit Verification by January 1, 2024 (texas.gov). The EVV HHCS Service Bill Codes Table posted on the EVV 21st Century Cures Act webpage in Excel and PDF formats. 

Next steps for providers:

All HHCS program providers and FMSAs that are new to EVV must register for a TexMedConnect account with TMHP. Click here for more information.

  1. Register for TexMedConnect
    • Claims for EVV services will be submitted to TMHP through TexMedConnect or through Electronic Data Interchange (EDI) using a Compass 21 (C21) Submitter ID.
    • Access TexMedConnect through the TMHP website. To use TexMedConnect, you must already have an account on the TMHP website. If you do not have an account, set one up using the information provided in the TMHP Website Security Provider Training Manual.
    • Program providers and FMSAs that need help setting up C21 or CMS Submitter IDs should contact the EDI Help Desk at 1-888-863-3638, Option 4.
  2. Request EVV Portal Access
    • To access the EVV Portal, program providers and financial management services agencies (FMSA) must have a TMHP User Account.
    • Program provider and FMSA staff must contact their TMHP Provider Administrator to request EVV Portal access.
    • For full instructions, review the EVV Portal job aids on the EVV Learning Management System (LMS)

How this impacts providers:

Claims Submission

  • Program providers and FMSAs must submit all HHCS EVV claims to Texas Medicaid and Healthcare Partnership (TMHP) starting with dates of service on or after December 1, 2023.
  • Texas Children’s Health Plan (TCHP) will reject any HHCS claims with EVV services and dates of service on or after December 1, 2023, back to the program provider and FMSA directing them to submit the claim to TMHP for EVV claims matching.

Next steps for providers: Providers should share this communication with their staff and ensure they register for a TexMedAccount with TMHP if one is not already made.

If you have any questions, please email Provider Relations at: providerrelations@texaschildrens.org.

For access to all provider alerts,log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.