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Reminder: No Discrimination Based on Client’s Vaccination Status

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Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to Medicaid members who are enrolled in their MCO. Administrative procedures, such as prior authorization, precertification, referrals, and claims and encounter data filing, may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the member’s specific MCO for details.

This is a reminder that, under House Bill (H.B.) 44, 88th Legislature, Regular Session, 2023, a Medicaid or Children's Health Insurance Program (CHIP) provider may not refuse to provide health care services to any Medicaid or CHIP client solely because the client refuses or fails to receive a vaccine or immunization for a specific infectious or communicable disease unless an exception applies under Texas Government Code §545.0205.

Effective April 29, 2025, the Texas Health and Human Services Commission (HHSC) enacted rules per Title 1 Texas Administrative Code (TAC) §354.1006, Prohibition of Provider Discrimination Based on Immunization Status for Medicaid, and Title 1 TAC §370.456, Prohibition of Provider Discrimination Based on Immunization Status for CHIP.

Texas Medicaid added this information to the Texas Medicaid Provider Procedures Manual (TMPPM), Provider Enrollment and Responsibilities, subsection 1.7.20, “Nondiscrimination for Vaccine Status,” on September 1, 2024.

For more information, call the TMHP Contact Center at 800-925-9126.