Flu Season Alert!Alerta de temporada de influenza:
Don’t let germs win this season – protect yourself and your family!
The flu vaccine is your best defense against flu and related complications – PLUS, it is a covered benefit for Texas Children’s Health Plan members! Learn more!
¡No permitas que los gérmenes ganen esta temporada! ¡Protégete a ti y a tu familia!
La vacuna contra la influenza es tu mejor defensa contra la influenza y sus complicaciones. Además, ¡es un beneficio cubierto para los miembros de Texas Children's Health Plan! Aprende más
Appointment Availability Standards Reminder for 2025
Date: July 18, 2025
Attention: Primary Care and Obstetric Care Providers
Call to action: Texas Children’s Health Plan (TCHP) would like to remind providers of the appointment availability standards. Senate Bill 760 passed, requiring Texas Health and Human Services Commission (HHSC) to monitor the provider networks of managed care organizations. Texas Children’s Health Plan would like to ensure members are able to schedule appointments with providers in accordance with the HHSC’s appointment accessibility guidelines.
Provider Type
Level/Type of Care
Appointment Accessibility Standards
OB/GYN
Low Risk Pregnancies
Provided within 14 calendar days
High Risk Pregnancies
Offered within 5 calendar days
New Members in the Third Trimester
Offered within 5 days
Primary Care
Urgent care
Within 24 hours
Emergency Care visit
Immediately or refer to ER
Routine primary care
Within 14 days
New child Member (< 20 years old) or adult preventive appointment
Within 90 calendar days
How this impacts providers: Texas Children’s Health Plan enforces access and other network standards required by the contract and takes appropriate action with providers whose performance is determined by the health plan to be out of compliance. In addition, providers and staff are responsible for understanding the requirements.
Primary Care Providers, a reminder that a referral is not required to see a TCHP in-network specialist.
Next step for Providers: Providers should share the appointment availability standards with their staff and if needed, implement internal procedures for compliance.
