Texas Migrant Care Network Webcast On Provider Enrollment

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High costs of health care and lack of insurance coverage are major barriers that impede many migrant families ability to access health care services.

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Texas Migrant Care Network Webcast On Provider Enrollment

  1. 1. Texas Migrant Care Network Jana Blasi, MPAff Deputy Director Texas Association of Community Health Centers, Inc.
  2. 2. Background <ul><li>High costs of health care and lack of insurance coverage are major barriers that impede many migrant families ability to access health care services. </li></ul><ul><li>Too difficult for families to attempt to enroll in various state Medicaid programs while they are temporarily out-of-state for work. </li></ul><ul><li>Reciprocity agreements among various states has been problematic for Texas. </li></ul>
  3. 3. Background <ul><li>Texas began to explore portability model, Texas Migrant Care Network (MCN), in 1998. </li></ul><ul><li>Focus on enrolling out-of-state providers who provide care to Texas migrants into the Texas Medicaid Program. </li></ul><ul><li>Out-of-State providers could then bill Texas Medicaid for provision of care to Texas Medicaid clients while they work out-of-state. </li></ul>
  4. 4. Background <ul><li>In late March 2008, Texas Medicaid contacted TACHC to identify out-of-state providers, especially FQHCs, interested in enrolling in Texas Medicaid to create Texas MCN. </li></ul><ul><li>Goal is to facilitate access to medical, dental and behavioral health services covered in Texas Medicaid by migrant children. </li></ul>
  5. 5. Texas Migrant Care Network <ul><li>Texas Medicaid Agency is willing to facilitate and expedite enrollment of out-of-state providers who traditionally serve Texas migrant families. </li></ul><ul><li>Focus of project is on migrant children who are currently enrolled in Texas Children’s Medicaid. </li></ul><ul><li>An estimated 200,000 to 300,000 MSFWs reside in Texas (at least 100,000 are children 0 – 19) </li></ul>
  6. 6. Texas Migrant Care Network <ul><li>Currently, this program is limited to Medicaid and CHIP is NOT included </li></ul><ul><li>This is not an expansion of Texas Medicaid and this program does not create a new eligibility category in Texas Medicaid. </li></ul><ul><li>MCN is only for migrant family members who are enrolled in Texas Medicaid prior to leaving Texas for out-of-state work. </li></ul>
  7. 7. Texas Medicaid Eligibility Levels and Groups <ul><li>Texas Children’s Medicaid Include: </li></ul><ul><li>Ages 0 to 1 up to 185 % of FPL </li></ul><ul><li>Ages 1 to 5 up to 133 % of FPL </li></ul><ul><li>Ages 6 to 18 up to 100 % of FPL </li></ul><ul><li>Pregnant Women up to 185 % of FPL </li></ul><ul><li>Women’s Health Program eligibility includes Women between the ages of 18 to 44 up to 185 % of FPL </li></ul>
  8. 8. Texas Migrant Care Network <ul><li>Targeting FQHCs to participate in Texas MCN but other out-of-state providers are also welcome to participate. </li></ul><ul><li>State will pay FQHCs their PPS rate and other providers will receive Fee-For-Service Texas Medicaid Rates. </li></ul>
  9. 9. Challenges to Implementation <ul><li>Identify and enroll eligible MSFW families into Texas Medicaid </li></ul><ul><li>Educate MSFW families to maintain their TX Medicaid coverage while out-of-state </li></ul><ul><li>Outreach and case management services to let them know about TX MCN and where providers are that accept TX Medicaid </li></ul>
  10. 10. Challenges to Implementation <ul><li>Many MSFWs have already left the state </li></ul><ul><li>If any red flags on provider enrollment applications, could delay enrollment of providers into TX Medicaid </li></ul><ul><li>Billing issues related to MSFW “members” enrolled in Medicaid managed care rollout areas of the state </li></ul>
  11. 11. What TACHC is Doing <ul><li>TACHC is developing flyers targeting migrant families and out-of-state providers to educate them about this program. </li></ul><ul><li>Web page on the Texas Migrant Care Network has been developed and will used as an additional resource of information for both migrant families, health care providers and advocates </li></ul><ul><li>Visit www.tachc.org </li></ul>
  12. 12. What TACHC is Doing <ul><li>Acting as a liaison between the TX Medicaid Program and PCAs and their members to facilitate the development of the out-of-state networks and to answer questions regarding: </li></ul><ul><li>- Provider Reimbursement </li></ul><ul><li>- Billing </li></ul><ul><li>- Provider Enrollment </li></ul>
  13. 13. What TACHC is Doing <ul><li>Providing staff to provide TA, training and to troubleshoot issues with out-of-state providers enrolling into TX Medicaid </li></ul><ul><li>Working with the state to develop effective outreach strategies </li></ul><ul><li>Advising state on administrative policies related to billing and enrollment of providers to facilitate the development of the out-of-state network and trouble free billing </li></ul>
  14. 14. What You Can Do <ul><li>Help TACHC get the word out about the Texas MCN to your state PCA </li></ul><ul><li>Get the word out to other FQHCs in your state and other states that see a high volume of Texas migrant families. </li></ul><ul><li>Advise your Texas migrant families to enroll in Texas Medicaid and/or maintain their Texas Medicaid coverage when they travel out-of-state. </li></ul>
  15. 15. Texas Migrant Care Network <ul><li>For More Information on Policy Issues </li></ul><ul><li>Contact: </li></ul><ul><li>Jana Blasi </li></ul><ul><li>512.329.5959 or [email_address] </li></ul><ul><li>Information on how to Enroll as a Provider in TX Medicaid </li></ul><ul><li>Contact: </li></ul><ul><li>Veronica Escobar </li></ul><ul><li>512.506.7380 or [email_address] </li></ul>

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