Watch for Behavioral Health Provider Satisfaction Survey

You’ll be contacted by email or mail if selected to participate. The survey measures your satisfaction with us and identifies areas where we can improve.

We’ll Conduct Postpayment Reviews on Medicaid Claims

Beginning Oct. 2, 2026, we’ll conduct Medicaid claim postpayment audits to correct billing inconsistencies and ensure coding accuracy and medical policy alignment.

See Prior Authorization Changes for Some Commercial and Government Program Members

We’ve updated prior authorization requirements for some commercial and government plans to reflect new, replaced or removed codes.

Take Note of Change in Recommended Clinical Review Request Process

Effective Aug. 15, 2026, we’re retiring the recommended clinical review request process through the Availity^® Essentials Attachments tool. You may continue to submit requests online through Availity Authorizations and by fax and phone.

Encourage Routine Vaccines and Well‑Care Visits for Children and Adolescents

We track quality measures on immunizations for adolescents and preventive care visits for members ages 3 to 21. See tips to close care gaps.

Avoid Antibiotics for Acute Bronchitis and Other Viruses

With back‑to‑school season approaching, consider talking with our members about taking antibiotics only when needed. See alternatives to antibiotics and information to share.

Discuss Preventive Care With Members

To reduce the risk of problems or catch them early, consider encouraging our members to seek preventive care, when appropriate. Review tips and preventive care guidelines.

Explore Learning Opportunities

We offer free training for providers who participate in our networks. View and sign up for sessions.

Complete Your Required Medicaid Revalidation

Medicaid providers are required to revalidate with the Texas Medicaid & Healthcare Partnership in the Provider Enrollment and Management System before your due date. See how to check your due date and complete revalidation.

Follow‑Up Care Is Recommended for Children Prescribed ADHD Medication

Attention deficit/hyperactivity disorder is one of the most common behavioral health disorders affecting children. To support quality care, we gather data on follow‑up visits for children using ADHD medication.

Register for Medicaid Provider Advisory Group Meeting in August

We’ll discuss clinical practice guidelines, member benefits and other topics at our third‑quarter meeting. View dates and times for both service delivery areas.

Reminder: Activate Your TMHP IAMOnline Account

The Texas Medicaid & Healthcare Partnership has moved additional applications to the TMHP IAMOnline platform. Activate your account if you haven’t already done so.

Stay Updated on Medicaid News

You can find information for STAR, STAR Kids and CHIP in Medicaid News and Updates.

Review PEAQ^SM Methodology Updates for 2026

The updated methodology for our Provider Efficiency, Appropriateness, & Quality^SM program is now available. This methodology explains how PEAQ evaluates provider performance.

Marketplace Members Rate Satisfaction With Providers

Through the annual Qualified Health Plan Enrollee Experience Survey, members provide feedback on their experiences with their health plan and its contracted providers. See key findings from 2025.

Review Pharmacy Program Quarterly Updates – Part 2

We’ve made changes to our drug lists and utilization management program. Learn about these and other pharmacy program updates.

Learn About Updates to Reimbursement Policies

We regularly add and modify reimbursement policies, formerly known as clinical payment and coding policies, as part of our ongoing policy review. See which policies were updated.

Review Active and Pending Medical Policies

Approved new or revised medical policies and their effective dates are usually posted on our website the first and 15th of each month. You can view all active and pending policies, as well as draft medical policies, and provide comments on draft policies. These policies may impact your reimbursement and your patients’ benefits.