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

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This is an update to the article titled “Prior Authorization Requests for DMEPOS Replacements Due to the Central Texas Floods Being Expedited,” which was published on tmhp.com on July 28, 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 2025 Central Texas floods. TMHP is also waiving submission time frames and documentation requirements for new prior authorization requests to replace DMEPOS.

Important Updates

TMHP has removed the requirement that clients must be permanent residents of the disaster-designated county.

The expediting of prior authorization is in effect through September 29, 2025, and is available statewide to clients of Texas Medicaid and the Children with Special Health Care Needs (CSHCN) Services Program who were impacted by the 2025 Texas flooding in a declared disaster county.

Requirements for Expedited Prior Authorization

Providers must specify in the prior authorization request that the need is a result of the 2025 Central Texas floods and include an explanation of why the equipment must be replaced.

Providers must keep documentation that indicates whether the DMEPOS were lost, destroyed, irreparably damaged, or cannot be used 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.