Recent News

Texas Health Steps benefit changes cover PPD and adolescent mental health screening

Two changes in mental health screening benefits are available through Texas Health Steps beginning July 1, 2018.

Maternal postpartum depression screening will become a benefit during an infant’s Texas Health Steps checkup. Maternal postpartum depression screening may be completed during a Texas Health Steps checkup, prior to the infant’s first birthday. Providers may receive separate reimbursement for the screening, in addition to reimbursement for the checkup. A validated postpartum depression screening tool must be used.

Texas Health Steps will allow reimbursement for annual mental health screenings, using an approved screening tool, for adolescents 12 through 18 years of age. Providers may receive separate reimbursement annually for the screening, in addition to reimbursement for the checkup.

For more information on changes to mental health screenings during a Texas Health Steps checkup, please visit the Texas Health Steps website.

New regulations restrict opioid cough and cold prescriptions

Effective April 2, opioid cough and cold medications will not be covered by Texas Medicaid fee-for-service for individuals 17 years and younger. The new restriction is based on the U.S. Food and Drug Administration’s recent decision to require safety labeling that limits the use of prescription cough cold medication containing codeine or hydrocodone to individuals 18 years and older.

Consult the Health and Human Services Vendor Drug Program for more information and a list of drugs on the Medicaid formulary that are affected by the change. Physicians and pharmacists should consult a patient’s Medicaid managed care organization for claim limitation requirements.

Hurricane Harvey resources for Medicaid providers

Texas Health and Human Services has launched a web page to provide pertinent Hurricane Harvey information to Texas Medicaid and CHIP providers. The web page provides updated links and resources for health-care and pharmacy providers who serve people affected by the hurricane. Information applies to patients who are covered by Medicaid fee-for-service and managed care. The web page will be regularly updated throughout the emergency situation.

A companion web page is available to assist members of the public who need disaster assistance.

LeadCare Analyzers not approved for venous blood testing

Texas Health Steps providers should not use Magellan Diagnostics’ LeadCare analyzers for venous blood lead tests. The Centers for Disease Control and Prevention (CDC) issued a Health Advisory warning that the analyzers may underestimate blood lead levels and provide falsely low test results. The FDA recommends against using LeadCare analyzers for venous blood samples.

The safety alert does not apply to capillary blood lead test results collected by fingerstick or heelstick. Texas Health Steps providers may continue to use LeadCare II Analyzers for point-of-care blood lead screening when testing capillary samples.

Visit the CDC Health Advisory website for more information about the safety alert.

RSV season ends April 14

The 2016-17 Respiratory Syncytial Virus (RSV) season will end April 14 for all Texas counties. No extensions were granted this season based on recommendations from the Texas Pediatric RSV Task Force.

Coverage of Synagis (palivizumab) will end April 14 for people enrolled in Medicaid (both traditional and managed care) and the Children with Special Health Care Needs services program. Pharmacy claims and prior authorization requests will not be accepted or reviewed after that date.