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On September 15, 2017 the Texas Health and Human Services Commission sent out the following Hurricane Harvey Prior Authorization Information. 

Will HHSC allow managed care organizations and the Texas Medicaid & Healthcare Partnership to extend prior authorizations?
MCO

  • Yes, MCOs may extend prior authorizations for authorizations expiring Aug. 25, 2017, through the termination of the emergency period for individuals with a permanent residence in a FEMA-declared disaster county for up to 90 days.

TMHP

  • HHSC will publish specific information for prior authorizations associated with services paid by TMHP.

 
Will HHSC allow MCOs and TMHP to have flexibility in documentation for any new authorizations?
MCO

  • Yes, HHSC will allow MCOs to waive currently required provider documentation, MCO and HHSC review criteria, required consultation requirements for authorization, review and documentation requirements of the state plan, contract or limitation of services when the following conditions are met: the individual has a permanent residence in a FEMA-declared disaster county, and the MCO determines that the information required to support the authorization or claim is not immediately available for reasons related to the disaster.
  • This flexibility is allowed from Aug. 25, 2017, through the termination of the emergency period for up to 90 days.

TMHP

  • HHSC will publish specific information regarding flexibilities for new authorizations associated with services paid by TMHP.
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