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Prior Authorization Requests for DMEPOS Replacements Due to the Central Texas Floods Being Expedited

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Effective July 2, 2025, the Texas Medicaid & Healthcare Partnership (TMHP) is expediting the processing of new prior authorization requests and recertifications to replace durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) that were lost or damaged as a result of the Central Texas Floods. TMHP is also waiving submission timeframes and documentation requirements for new prior authorization requests to replace DMEPOS.

Providers must specify in the prior authorization request that the need is a result of the Central Texas Floods and include an explanation of why the equipment must be replaced.

Important: This is effective from July 2, 2025, until 90 days after the disaster declaration has been ended and is limited to providers that provide services to Texas Medicaid and Children with Special Healthcare Needs Services Program (CSHCN) clients who permanently live in a declared disaster county.

Providers must keep documentation that indicates whether the DMEPOS were lost, destroyed, irreparably damaged, or cannot be used all because of the flooding. The services that providers deliver may be subject to retrospective review for medical necessity.

For more information, call the TMHP Contact Center at 800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 800-568-2413.