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Senate Bill (SB) 750, 86th Texas Legislature, Regular Session, 2019, directs the Health and Human Services Commission (HHSC) to implement an enhanced, cost-effective, and limited postpartum care services package for women enrolled in Healthy Texas Women (HTW). The new benefit package is to be provided after the first 60 days of the postpartum period, and for a period of not more than 12 months after the date of enrollment in HTW. The enhanced postpartum services package is called HTW Plus. Women in HTW Plus will have access to both HTW and HTW Plus benefits.
HTW currently provides a wide variety of women’s health and core family planning services, including:
- Pregnancy testing
- Pelvic examinations
- Sexually transmitted infection services, including HIV screening
- Breast and cervical cancer screenings, including clinical breast examination and mammograms
- Screening and treatment for cholesterol, diabetes and high blood pressure
- HIV screening
- Family planning services, including: long-acting reversible contraceptives; oral contraceptive pills; permanent sterilization; and other contraceptive methods such as condoms, diaphragm, vaginal spermicide, and injections
- Screening and pharmaceutical treatment for postpartum depression
HTW Plus Benefits
The HTW program has developed an enhanced postpartum care service package for women enrolled in the HTW program called HTW Plus. To qualify for HTW Plus benefits, HTW clients must have been pregnant within the last 12 months.
HTW Plus services will focus on treating major health conditions recognized as contributing to maternal morbidity and mortality in Texas, including:
- Postpartum depression and other mental health conditions
- Services include individual, family and group psychotherapy services; and peer specialist services.
- Cardiovascular and coronary conditions
- Services include imaging studies; blood pressure monitoring; and anticoagulant, antiplatelet, and antihypertensive medications.
- Substance use disorders, including drug, alcohol and tobacco use
- Services include screening, brief intervention, and referral for treatment (SBIRT), outpatient substance use counseling, smoking cessation services, medication-assisted treatment (MAT), and peer specialist services.
Click here to view a table containing the procedure codes that will be effective for dates of service beginning September 1, 2020
To view pharmacy benefits for HTW Plus, providers can visit the HHSC Vendor Drug Program website and click on HTW Plus delimited file: www.txvendordrug.com/resources/downloads.
The new HTW Plus benefits will be available on September 1, 2020. Providers can begin to submit claims October 1, 2020 for the HTW Plus services.
HTW Plus Provider Enrollment
There is no additional requirement for current HTW providers to provide HTW Plus services.
To become an HTW provider, providers must enroll in Texas Medicaid through the Texas Medicaid & Healthcare Partnership (TMHP). Providers can choose one of the following enrollment methods:
- Apply online. Go to TMHP.com and select “providers” in the banner at the top of the page, and then select “Enroll Today!” in the banner at the top of the page. Follow the onscreen instructions.
- Submit a paper application. Go to TMHP.com and follow the instructions above, then go to the Forms page. Scroll down to “Provider Enrollment – Applications” to access and download the enrollment forms for printing.
Request an enrollment package from TMHP by phone at 800-925-9126, or by mail at:
Texas Medicaid & Healthcare Partnership ATTN: Provider Enrollment
PO Box 200795
Austin, TX 78720-0795
Important: To serve HTW Plus members, providers must first enroll as Medicaid providers by following the steps above, and then be certified by HTW.
To determine if a client is eligible for HTW Plus, call 1-866-993-9972. For HTW Plus questions, call 1-800-925-9126, Option 5.