Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to eligible clients. Administrative procedures such as prior authorization, pre-certification, referrals, and claims/encounter data filing may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the client's specific MCO for details.
This is a correction to the article titled, “Home Health DME and Supplies Exceptional Circumstances Provision for Medicaid Clients 21 Years of Age and Older,” which was published on this website on April 29, 2020.
The article indicated that the Exceptional Circumstances provision is made available in accordance with Texas Administrative Code (TAC) 42 CFR § 440.70 (b) (3) (v), and 1 TAC § 354.1039 (a) (4) (D).
The correction is that the Exceptional Circumstances provision is made available in accordance with: 42 Code of Federal Regulations (CFR) § 440.70 (b) (3) (v), and 1 Texas Administrative Code (TAC) § 354.1039 (a) (4) (D).
For more information, call the TMHP Contact Center at 800-925-9126.