Health and Human Services Commission (HHSC) Updates

Welcome El Paso Health Providers! This page is intended for El Paso Health Network Providers to obtain related information and resources from HHSC. Please continue to visit the TMHP website for provider notifications and guidance. If you need further assistance, please contact the El Paso Health Provider Relations Department for STAR/CHIP at 915-532-3778 or STAR+PLUS at 833-742-3127.

External Medical Review

In accordance with Tex. Gov’t Code Section 531.024162, as amended by Senate Bill 1207,  HHSC is required to contract with an independent review organization (IRO) to perform external medical reviews (EMR) when requested by Medicaid members for certain benefits that have been denied, reduced, or terminated by their MCO or DMO.

The purpose of this training is to Provide an overview to providers on the role and responsibilities for participants involved in an external medical review following receipt of an appeal decision from El Paso Health.

Please click on the following links for presentation:

• External Medical Review (EMR) Provider Training – PDF Version
• External Medical Review (EMR) Provider Training – Live video recording of training

Resources

• Hepatitis C Prescriber Letter – Texas Medicaid HepCure
• Process for Provider Reporting of Therapy Waiting Lists
• Therapy Waitlist Provider Reporting Template
• The Texas Long-Acting Reversible Contraception Toolkit
• Special Supplemental Nutrition Program for Women, Infants and Children (WIC)
• Prenatal Screening for Domestic Violence and Substance Use
• Medicaid Fraud Notice for Providers
• Important information on Abuse, Neglect and Exploitation
• Important Information Regarding Zika
• Texas Health Steps Information for Providers