TMPPM 2008 > Provider Information > Front Matter > Introduction - Medicaid Program Administration

Introduction - Medicaid Program Administration

The Texas Medical Assistance (Medicaid) Program was implemented on September 1, 1967, under the provisions of Title XIX of the federal Social Security Act and Chapter 32 of the Texas Human Resources Code.

The State of Texas and the federal government share the cost of funding the Texas Medicaid Program. The Health and Human Services Commission (HHSC), the single state Medicaid agency, is responsible for the Title XIX Program. The administration of the program is accomplished through contracts and agreements with medical providers; Texas Medicaid & Healthcare Partnership (TMHP), the claims administrator; MAXIMUS, the enrollment broker; various managed care organizations (MCOs); the Institute for Child Health Policy (ICHP), the quality monitor; and state agencies. Texas Medicaid providers are reimbursed for services through contracts with health-insuring contractors, fiscal agents, or direct vendor payments.

By signing an HHSC Medicaid Provider Agreement and submitting Medicaid claims, each enrolled provider agrees to abide by the policies and procedures of Medicaid, published regulations, and the information and instructions in manuals, bulletins, and other instructional material furnished to the provider.

Additional information is also provided on the TMHP website at www.tmhp.com. To find information about the various TMHP resources, visit the TMHP website, where the following information can be accessed:

•Workshop information.

•Regional provider relations representatives.

•Publications (manuals, bulletins, etc.).

•Panel reports.

•Eligibility inquiries.

•Claim status inquiries.

•Remittance and Status (R&S) reports.

•Primary Care Case Management (PCCM) regional provider listings.

•PCCM client handbook and other client information.

Refer to: "State and Federal Offices Communication Guide" for addresses and telephone numbers of HHSC and Department of State Health Services (DSHS) regional offices.