PCCM Enrollment Issue Identified

The Texas Health and Human Services Commission (HHSC) recently identified an issue with Primary Care Case Management (PCCM) that may affect a small number of Medicaid clients.

Some Medicaid clients who do not live in a PCCM expansion county were enrolled in PCCM by mistake. Clients are enrolled in PCCM based on a county code designation and some county code designations were incorrectly entered.

HHSC anticipates that this problem will be corrected by August 19, 2005. HHSC will correct the problem with county code designations and disenroll clients from PCCM who do not live in an expansion county. The clients’ September 1, 2005, Medicaid Identification Form (Form H3087) should reflect the correction.

After September 1, 2005, providers who believe there is a mistake in PCCM enrollment should call the PCCM Provider Helpline at 1-888-834-7226. To facilitate prompt handling, please include the client’s Medicaid ID number.

Thank you for your continued support of the PCCM expansion.