To say the past nine months have been busy for HHSC’s Medicaid/CHIP Division is something of an understatement.
Since last June, HHSC has conducted an ambitious list of activities — everything from reworking the Medicaid ID to expanding Medicaid managed care statewide — all designed to transform and improve Medicaid service delivery in Texas.
“In less than a year, we have made significant improvements in the way people interact with Medicaid and get services,” said Texas Medicaid Director Billy Millwee. “When I look at all these projects together, I am amazed at what our talented and dedicated staff members have been able to do in such a short amount of time.”
The most recent and most publicized of these projects has been the expansion of Medicaid managed care in more than 200 Texas counties. In the last nine months, HHSC has guided more than a million Medicaid members from traditional Medicaid and Primary Care Case Management (PCCM) to STAR and STAR+PLUS managed care Medicaid. For the changes taking effect March 1, HHSC staff and vendors developed and mailed information packets — customized more than 50 different ways to meet the needs of each individual Medicaid member — and conducted more than 800 community events designed to help members make a smooth transition to managed care medical plans. HHSC conducted more than 50 training sessions for providers in 21 Texas cities. Web-based versions of the provider training sessions and other information about the expansion are posted on the HHSC website.
Before embarking on that statewide expansion, HHSC changed the managed care model itself, making Medicaid pharmacy benefits part of the package of services now provided by Medicaid medical plans. Dental services for children and young adults age 20 and younger are also now provided through managed care dental plans.
Those changes were incorporated into the procurement and reprocurement of contracts for managed care health plans to provide CHIP and Medicaid services to the expanding statewide member base. As of March 1, a total of 92 different medical plans are providing services to people with Medicaid and CHIP. Each person with coverage has at least two medical plans to choose from and in many parts of the state members have a choice of three or more plans. Children age 20 and younger with Medicaid or CHIP also can choose from three statewide dental plans.
Meanwhile, the Medicaid community is becoming more familiar with another recent addition — the plastic Your Texas Benefits Medicaid card that replaced the paper Medicaid ID clients used to get in the mail each month. The first wave of the new plastic cards hit mailboxes last August. Those with Medicaid can expect to receive a new Your Texas Benefits Medicaid card — this one showing the member’s medical and dental plan — in March or April. Answers to common questions about the Your Texas Benefits Medicaid card are posted on the HHSC website.
Features continue to be added to websites for Medicaid providers and Medicaid members. Providers can go to YourTexasBenefitsCard.com for up-to-date information on a patient’s eligibility and history of services and treatments paid by Medicaid. People who are covered by Medicaid can log in to YourTexasBenefits.com and get information about their case and services Medicaid will cover. They also can find which Texas Health Steps checkups they need and print paper copies of their Your Texas Benefits Medicaid card.