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 Hurricane Ike Provider Information

Healthcare Services for Ike Evacuees

The Texas Health and Human Services Commission (HHSC) anticipates that federal legislation will be filed to provide relief for uninsured Hurricane Ike evacuees who seek medical care. While HHSC awaits Congressional action, providers should be aware of information that may be necessary to process claims for services provided to uninsured evacuees.

It is important to understand that unless Congress authorizes funds, there is no guarantee that reimbursement will be made available for the treatment of uninsured evacuees; however, in the event that Congress does not authorize funds, HHSC will still need to track the cost of uncompensated care.

If an evacuee seeks services, providers should collect the following information:

  • Name and Social Security number
  • Citizen status
  • County and ZIP code where evacuee resided before the hurricane (Click here to see covered counties/ZIP codes)
  • Monthly income
  • Evacuee attestation that they are uninsured
  • Demographics, including:
    • Age
    • Gender
    • Race
  • Household composition, including the following information about people in the client's household:
    • Names of others in the household
    • Ages of others in the household
    • Relationship to client
  • FEMA Registration ID Number
  • Signature of client

HHSC will provide more information about when to file claims, what period of time will be covered, and other important details regarding reimbursement for providers as soon as Congress acts. HHSC thanks providers for their ongoing efforts to provide services to the victims of Hurricane Ike and for the work they do to support clients of Texas Medicaid.


Primary Care Case Management Program (PCCM)

Primary Care Provider Referral

HHSC is suspending the requirement for a primary care referral for Medicaid clients who are in the PCCM delivery model and live in a hurricane evacuation area.

Please note that claims submitted for these clients will initially deny but will then be reprocessed with no additional action required from the provider. This process is only applicable for clients who live in ZIP codes under evacuation orders.

Prior Authorization

HHSC is suspending the prior authorization requirement for Medicaid clients who are in the PCCM delivery model and live in a hurricane evacuation area. However, the services delivered may still be subject to retrospective review for medical necessity.

Please note that claims submitted for the clients will initially deny but then will be processed with no additional effort from the provider. This process is only applicable for clients who live in ZIP codes under evacuation orders.

Claim Filing Deadline to Be Waived for Services to Ike Evacuees

In response to Hurricane Ike, HHSC has directed TMHP to waive the filing deadline for services rendered by Texas Medicaid providers whose ZIP codes have been identified as being in an evacuation area. The waiver applies to claims received with dates of service on or after September 9, 2008, and through January 31, 2009.

Claims submitted after the filing deadline will initially be denied but will then be reprocessed by TMHP with no further action required by the provider.

This waiver does not apply to the 365-day federal filing deadline, which will not be overridden. The filing deadline will be waived only for providers whose ZIP codes have been identified by HHSC as an evacuation area.

Important: The filing deadline waiver for providers whose ZIP codes have been identified as Hurricane Ike evacuation areas was discontinued effective February 1, 2009. Impacted providers must file any remaining claims with dates of service from September 9, 2008, through January 31, 2009, within 95 days of February 1, 2009 (i.e., claims must be received by May 7, 2009).

Fee-For-Service Clients

Prior Authorization

HHSC is suspending the prior authorization requirement for Medicaid clients who receive fee-for-service Medicaid and live in a hurricane evacuation area. However, the services delivered may still be subject to retrospective review for medical necessity

Claim Filing Deadline to Be Waived for Services to Ike Evacuees

In response to Hurricane Ike, HHSC has directed TMHP to waive the filing deadline for services rendered by Texas Medicaid providers whose ZIP codes have been identified as being in an evacuation area. The waiver applies to claims received with dates of service on or after September 9, 2008, and through January 31, 2009.

Claims submitted after the filing deadline will initially be denied but will then be reprocessed by TMHP with no further action required by the provider.

This waiver does not apply to the 365-day federal filing deadline, which will not be overridden. The filing deadline will be waived only for providers whose ZIP codes have been identified by HHSC as an evacuation area.

Important: The filing deadline waiver for providers whose ZIP codes have been identified as Hurricane Ike evacuation areas was discontinued effective February 1, 2009. Impacted providers must file any remaining claims with dates of service from September 9, 2008, through January 31, 2009, within 95 days of February 1, 2009 (i.e., claims must be received by May 7, 2009).


Medicaid/CHIP Health Maintenance Organizations

Superior HealthPlan

For information on a Medicaid client who has Superior HealthPlan, visit their website at https://www.superiorhealthplan.com

For information on Medicaid clients who are in:

  • STAR, STAR+PLUS and CHIP, call 1-877-391-5921
  • CHIP EPO, call 1-800-522-8923
  • STAR Health, call 1-866-439-2042

Amerigroup health plan info

https://www1.amerigroupcorp.com/providers/ProviderPortalWeb/publicpages/tx/

Evercare

http://evercarehealthplans.com/medicaid_texas.jsp#B

Member and Provider Services Hotline: 1-888-887-9003

Molina

www.molinahealthcare.com/medicaid/members/tx/home.html

Provider Services Hotline: 1-877-665-4622

United Healthcare

www.uhc.com

www.unitedhealthcareonline.com/b2c/CmaAction.do?view
Key=PreLoginMain&forwardToken=PreLoginMain

Provider Services Hotline: 1-877-842-3210

Driscoll

www.dchpkids.com

Provider Services Helpline: 1-877-220-6376

Community HealthChoice

www.communityhealthchoice.org
 
Provider Services Helpline: 1-888-760-2600

Texas Children’s Health Plan

www.texaschildrenshealthplan.org

Provider Services Helpline: 1-832-828-1004


Medicaid/CHIP Vendor Drug Program

September 16, 2008 - Temporary Doctor's License Numbers for Hurricane Ike

Pharmacy prescribers that are licensed out-of-state may help with the hurricane disaster efforts.  Texas Medicaid requires a valid prescriber license number as part of the prescription adjudication process.  To facilitate this adjudication process, the Vendor Drug Program has created a universal prescriber license number to be used by any physician who is not licensed in the State of Texas. When submitting out-patient prescription claims to the Vendor Drug program, pharmacies may use the following information for any out-of-state prescriber who is writing a prescription for a hurricane disaster client: “IKEØ1” in “Prescriber ID” (411-DB) “Disaster” in “Prescriber Last Name” (427-DR) More information about Hurricane Ike emergency procedures is available via the Vendor Drug website http://www.txvendordrug.com/.

September 14, 2008: Vendor Drug Program

Hurricane Ike Pharmacy Notice


Medical Transportation Program

If your patient needs a ride to evacuate a hurricane-affected area, they can call 2-1-1 or 9-1-1 for information to get help.

If your patient has arranged for a ride to a medical appointment, Medical Transportation staff will call them if the ride is cancelled because of the hurricane.

If the patient’s ride is cancelled, but the appointment is still scheduled, the patient can call 2-1-1 for help. If a Medicaid client needs a ride to the doctor, drug store, or clinic, the person can call 1-877-633-8747 Monday through Friday, 8 a.m. through 5 p.m. The scheduler will need the person’s Medicaid and Social Security numbers.

 
   
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