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Beginning August 12, 2022, the Texas Medicaid & Healthcare Partnership (TMHP) will begin to suspend payment to the impacted provider types that have not submitted the required Senate Bill (SB) 809 Rider 143 Reports for COVID-19. The list of impacted providers can be found on the Provider Finance Department web page under Provider Finance Communications by selecting SB 809/Rider 143 COVID-19 Reporting Healthcare Institution List from the drop-down list.
The 87th Texas Legislature directed the Texas Health and Human Services Commission (HHSC) to report federal COVID-19 funding from specific health care institutions and certain costs those providers have spent related to the COVID-19 public health emergency. Impacted provider types that have not submitted their required reports will receive the following explanation of benefits (EOB) message that will show the amount and reason for payment suspension:
PAYMENT IN THE AMOUNT OF $______ SUSPENDED DUE TO NON-RECEIPT OF SB809/R143 COVID REPORTING
This message will also appear on future Remittance and Status (R&S) reports.
Impacted required provider types that are unable to meet the reporting deadline should contact the Provider Finance Department at firstname.lastname@example.org for assistance.
Important: Payments for claims billed with any Texas Provider Identifiers (TPIs) associated or linked to an impacted provider’s National Provider Identifier will also be suspended.
Avoid Payment Suspension
Impacted provider types can avoid suspension by submitting the required documentation online through the Provider Finance web page for the monthly report that is required by Rider 143 [2022-23 General Appropriations Act, Senate Bill (S.B.) 1, 87th Legislature, Regular Session, 2021 (Article II, HHSC, Rider 143) and S.B. 809 (87th Legislature, Regular Session, 2021], Texas Administrative Code (TAC) §355.7201 Novel Coronavirus (COVID-19) Fund Reporting.
Impacted provider types can also refer to a Frequently Asked Questions (FAQ) document that is located on the website listed above. Providers can view the HHSC-created list of frequently asked questions for answers to common questions to assist providers in completing the report.