Medicaid is the State and
Federal cooperative venture that provides medical coverage to eligible persons.
The purpose of Medicaid in Texas is to improve the health of people who might
otherwise go without medical care for themselves and their children. The Texas
Health and Human Services Commission's (HHSC) Medicaid Office is responsible for
statewide oversight of Texas Medicaid. For additional information, you can visit
the HHSC website.
Click on the links below for more details about Texas Medicaid.
Medicaid Contact Information
The mission of Texas Medicaid is to improve the health of Texans by:
Promoting continuity of care
Providing a medical home for Medicaid clients
Ensuring that each client can receive high quality, comprehensive health care
services within the client's community
Through this procurement, the State accomplishes its mission by contracting
for measurable results that improve client access and satisfaction; maximize
program efficiency, effectiveness, and responsiveness; and reduce operational
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The Texas Medicaid & Healthcare Partnership (TMHP): The
Texas Medicaid & Healthcare Partnership (TMHP) is a group of contractors under
the leadership of Accenture. Accenture administers Texas Medicaid and other
state health-care programs on behalf of the Texas Health and Human Services
Texas Health and Human Services Commission (HHSC): HHSC
provides leadership and direction, and fosters the spirit of innovation needed
to achieve an efficient and effective health and human services system for
Texans. HHSC has oversight responsibilities for designated
Health and Human Services
agencies , and administers certain health and human services programs
including Texas Medicaid, the Children's Health Insurance Program (CHIP), and
Medicaid waste, fraud, and abuse investigations. HHSC is responsible for the
Texas Medicaid Managed Care Program (State of Texas Access Reform or STAR and
STAR+PLUS). HHSC is also responsible for determining the client's Medicaid
Department of State Health Services (DSHS): DSHS administers
Children with Special Health Care Needs
(CSHCN) Services Program,
Texas Health Steps and
Family Planning programs.
Department of Aging and Disability Services (DADS): DADS,
along with HHSC, administers the
Long Term Care Programs (LTC).
Texas Legislature: The Texas legislature is responsible for
determining the budget of the Texas Medicaid Program.
Providers: Providers are the crucial players in a quality
health-care program. Providers focus on providing the best medical care
possible, while maximizing their reimbursement potential. The Medicaid Program
allows for the enrollment of many different types of providers. Please visit the
TMHP Provider Enrollment page.
Patients/Clients/Members: Patients/Clients/Members are the
Texas citizens that the Medicaid Program serves. All stakeholders play an
intricate role in the service that patients/clients receive.
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The claims administrator for various programs is the Texas Medicaid &
Healthcare Partnership (TMHP). There are a variety of programs that TMHP
Long Term Care Programs (LTC): Medicaid covers a broad range
of services for people who need assistance with day-to-day living. Such services
include nursing home care, facilities for people with mental retardation, and a
range of community care services for people with disabilities. These services
are typically referred to as long term care. For more information about LTC
Programs, visit the
TMHP LTC Programs provider page.
Family Planning (DSHS Family Planning Program and Title XIX Family
Planning Services): The Family Planning Program assists low-income
Texans to improve their health and to positively affect the outcome of future
pregnancies. For more information about Family Planning, visit the
TMHP Family Planning provider page
and/or visit the
Department of State Health Services (DSHS) Family Planning website.
Children with Special Health Care Needs (CSHCN) Services Program:
The CSHCN Services Program provides medical assistance to children who might
otherwise be unable to benefit from present or future educational or employment
opportunities. The CSHCN Services Program provides health benefits to qualified
families with children with special health-care needs and people with cystic
fibrosis. To be determined eligible for Program services, applicants must meet
the medical, financial, and other criteria as stated in the CSHCN Services
Program rules effective October 3, 2010. For more information about the Program,
TMHP CSHCN Services Program provider page.
Texas Health Steps Medical/Dental and Comprehensive Care Programs
(CCP): Formerly know as the Early and Periodic Screening, Diagnosis and
Treatment (EPSDT) Program, Texas Health Steps is the largest and most
comprehensive medical and dental prevention and treatment program for children
of low-income families. The program provides comprehensive and periodic
evaluation of a child's health, development, and nutritional status, as well as
vision, dental, and hearing care. Texas Health Steps is the gateway for
comprehensive health care for Medicaid enrolled children from birth to 21 years
of age in Texas. For more information about Texas Health Steps, visit the
TMHP Texas Health Steps provider
Department of State Health Services (DSHS) Texas Health Steps website .
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