Beginning August 1, 2021, Healthy Texas Women (HTW) providers prescribing medications to HTW clients must complete the HTW certification in order for these clients to receive the medication from a pharmacy. The Texas Health and Human Services Commission (HHSC) will no longer pay pharmacies for medications prescribed to HTW clients by providers who are not HTW certified.
Most provider types and specialties must complete a HTW certification to serve HTW clients and be reimbursed for HTW services. Providers can find more information about the certification requirements in the article “Update to ‘New HTW Provider Certification Requirements’,” which was published on the TMHP website on June 14, 2021.
Providers that have not completed HTW certification by August 1, 2021 risk their HTW clients not receiving their prescribed medication.
The following HTW providers are exempt from the HTW certification requirement, but they must still comply with all other HTW provider requirements to be considered for reimbursement:
- Independent laboratories
- Radiology providers
- Teaching hospitals
Providers that have a current HTW certification on file associated with their National Provider Identifier (NPI) do not need to take any action.
How To Complete the HTW Certification by August 1, 2021
Providers that do not have an HTW certification on file for their NPI can use the TMHP Provider Information Management System (PIMS) to complete the certification or to check certification status. For more information about using PIMS, refer to the Provider Information Management System (PIMS) Instructions for HTW Certification and Attestation.
HTW providers are required to recertify each calendar year, regardless of when the certification was completed during the previous calendar year. Providers can certify for the following calendar year beginning in November. The deadline to certify for the following calendar year is December 31.
For more information about HTW provider policies, including provider enrollment and the HTW certification, refer to the “Healthy Texas Women Program Handbook” of the Texas Medicaid Provider Procedures Manual.
For more information, call the TMHP Contact Center at 800-925-9126.