2025 Texas Flooding: Appeal and Continuation of Benefit Flexibility

Date: August 20, 2025

Attention: All Providers

Effective date: August 20, 2025

Call to action: In response to the 2025 Texas flooding,the Texas Health and Human Services Commission (HHSC) has directed managed care organizations (MCOs) to temporarily extend appeal and continuation of benefits timelines for impacted members:

• Appeal requests: Impacted members now have 90 days (extended from 60 days) to request an internal appeal.
• Continuation of benefits: Impacted members now have 30 days (extended from 10 days) to request continuation of benefits upon receipt of the adverse benefit determination.

These flexibilities apply statewide and are only available upon request by members impacted by the flooding. Members must indicate in their request that the extension is due to the 2025 Texas flooding.

Effective dates: These changes must be implemented immediately and apply retroactively to requests received between July 2, 2025, and September 29, 2025.

Next steps: Providers should share this communication with their staff. 

Additional Resources

• We encourage members who have been impacted to seek help by visiting CMS’ Emergency Preparedness Webpage. To find additional health sector resources, visit: PHE.gov Emergency Tools.
• Receiving Disaster Assistance (HHSC)
• Provider Alert: Lost or Irreparably Damaged DMEPOS During Central Texas Flooding (July 2025)

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

For access to all provider alerts,log into:
www.texaschildrenshealthplan.org/provideralerts.