Health Care Services for Rita Evacuees

On April 28, 2006, the Centers for Medicare and Medicaid Services (CMS) authorized Texas to cover health care services for Hurricane Rita evacuees.  The amendment covers health care provided to Hurricane Rita evacuees who reside in one of the covered counties or parishes and did not have other health insurance coverage. The coverage period is from September 23, 2005, to January 31, 2006.

Providers are eligible for reimbursement for services provided in accordance with Texas’ Medicaid State plan in place on September 23, 2005, and will be reimbursed at the Texas Medicaid rates. Benefits include health care, long-term care, prescription medicines, and medical transportation.

Services that were not part of Texas’ State plan on September 23, 2005, and are not eligible for reimbursement, include:

• Hearing aids.
• Eyeglasses and contact lenses.
• Services provided by podiatrists, chiropractors, licensed clinical social workers, licensed marriage and family therapists, licensed psychologists, and licensed professional counselors.

Providers will be able to file claims retroactively up to one year after the date of service for services provided during the coverage period.  To receive payment for services, providers will need to file claims through the Texas Medicaid system. Providers will receive specific instructions for filing claims as soon as possible.

For claims covered under this provision the following information, at a minimum, will be required: client name, Social Security number (if available), date of birth, sex, age and zip code. The client’s zip code must be in a declared disaster area for the claim to be eligible for payment. The claims submitted also must include services provided and dates of service.

Claims may not be submitted for services that a provider has received payment from an individual or organization as part of a public or private hurricane relief effort.

Uncompensated care claims paid through this provision cannot be counted as uncompensated care in the hospital-specific disproportionate share hospital limit as defined in section 1923(g)(1)(A) of the Social Security Act. Claims will be retrospectively reviewed.

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