November 9, 2022
What is New
To comply with the American Rescue Plan Act’s (ARPA) amendment to Sections 2103(c)(11)(B) and 2103(e)(2) of the Social Security Act, Blue Cross and Blue Shield of Texas (BCBSTX) must provide COVID-19 vaccines, COVID-19 test kits, and COVID-19 treatments without imposing co-payments to CHIP members. BCBSTX will cover services for COVID-19, including:
- Vaccines
- Testing
- Treatment of COVID-19, including preventative therapies and treatment of post-COVID-19 conditions (long-haul COVID-19)
- Treatment during the time the member is diagnosed with COVID-19
- Treatment during the time the member is presumed to have COVID-19
- Treatment of health conditions that may seriously complicate the treatment of COVID-19
- Examples of these health conditions include, but are not limited to, cardiovascular diseases, chronic lung diseases, diabetes, cancer, obesity, Down Syndrome, and being a recipient of a transplant or immunosuppressive therapy.
For dates of services on and after December 21, 2022, Texas Health and Human Services Commission (HHSC) will use the non-risk payment process to reimburse BCBSTX for the additional payment to non-pharmacy providers for copay not collected regarding ARPA requirements. HHSC will use the encounter data submission process to track BCBSTX reimbursement.
Before reimbursement of providers, we must collect attestations from providers verifying copays were not collected. Providers can use the attestation form and submit an invoice to us. We have 30 calendar days to pay an invoice received from a provider. Attestation forms do not have to be submitted to HHSC but can be requested at any time.
Resources:
Questions
Providers, for questions or additional information, please:
- Contact your BCBSTX Medicaid Network team at 1-855-212-1615 or
- Submit via email to Texas Medicaid Network Department