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
Call to action: The purpose of this communication is to inform providers that effective September 1, 2025, Rider 32 will be implemented. Rider 32 transitions dually eligible individuals enrolled in Medicaid managed care from a fee-for-service (FFS) model to a Medicaid-only managed care service delivery system.
Starting September 1, 2025, providers will be required to bill Managed Care Organizations (MCOs) directly for the Medicaid-only acute care services provided to dually eligible members that MCOs cover for members who do not have Medicare.
Next steps: We understand providers may have questions about how Rider 32 will impact their practice. Additional details – including which providers are affected, relevant CPT codes, and billing guidance – will be shared in the coming months. Additionally, Texas Children’s Health Plan will also conduct targeted outreach to impacted providers as the September 1, 2025, effective date approaches. Please check back soon for additional updates and information.
