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Prior Authorization Requests for DMEPOS Replacements Due to Hurricane Beryl Being Expedited

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Effective July 8, 2024, the Texas Medicaid & Healthcare Partnership (TMHP) is expediting the processing of new prior authorization requests and recertifications to replace durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) that were lost or damaged as a result of Hurricane Beryl. TMHP is also waiving submission timeframes and documentation requirements for new prior authorization requests to replace DMEPOS.

Providers must specify in the prior authorization request that the need is a result of Hurricane Beryl and include an explanation of why the equipment must be replaced.

Important: This change is effective from July 8, 2024, until 90 days after the emergency declaration has been ended. It is limited to providers that provide Medicaid-covered services to Texas Medicaid-, Children with Special Healthcare Needs Services Program (CSHCN)-, and Children’s Health Insurance Program (CHIP)-eligible clients who permanently live in a declared disaster county.

Providers must keep documentation that indicates whether the DMEPOS were lost, destroyed, irreparably damaged, or cannot be used at all because of the hurricane. The services that providers deliver may be subject to retrospective review for medical necessity.

For more information, call the TMHP Contact Center at 800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 800-568-2413.