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.
The Texas Health and Human Services Commission (HHSC) has announced that supplies and accessories for the Omnipod® Insulin Management System, also known as Omnipod Eros/Classic, will still be available to existing Texas Medicaid clients through December 31, 2023. The Eros/Classic products are not available to new users due to the manufacturer’s decision to discontinue the model.
HHSC is reviewing potential alternate ways for Texas Medicaid members to receive the Omnipod 5. HHSC will continue working on resolving coverage of this product, and providers will be notified as updates become available.
For more information, call the TMHP Contact Center at 800-925-9126.