The Vendor Drug Program (VDP) made changes to the Texas Medicaid drug formulary effective January 30, 2026. To learn more about formulary changes impacted, please click here for more information
Guidance on Member Allegations of Provider Discrimination Based on Immunization Status
Date: August 30, 2024
Attention: Providers
Update to Texas Medicaid Provider Procedures Manual: September 1, 2024
Call to action: The purpose of this communication is to inform providers of an update being made to the Texas Medicaid Provider Procedures Manual (TMPPM) on September 1, 2024 by the Texas Medicaid & Healthcare Partnership (TMHP). Section 1.7, Provider Responsibilities will read as follows, “ In accordance with H.B. 44, Medicaid providers are prohibited from refusing to provide health care services to any Medicaid client based solely on the client’s refusal or failure to obtain a vaccine or immunization for a particular infectious or communicable disease unless excepted by Texas Government Code §531.02119.”
Where to report non-compliance
- Allegations of provider discrimination based on vaccine status are handled by HHSC and not by Texas Children’s Health Plan (TCHP), as applicable.
- HHSC receives these allegations through the HHS Office of Ombudsman.
- Ways to reach the HHS Office of Ombudsman include:
- Toll-free phone call to the Managed Care Assistance Team 1-866-566-8989. A person who has a hearing or speech disability, call 7-1-1 or 800-735-2989.
- Online at https://hhs.texas.gov/omcat.
- Faxing toll-free to 888-780-8099.
- Mailing to: Texas Health and Human Services Commission, Office of the Ombudsman, MC H-700, P.O. Box 13247, Austin, Texas 78711-3247.
Next step for Providers: Providers must adhere to the guidance outlined here and share this communication with their staff.
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.