Signature Updates to Home Health Prior Authorization Request Forms

Date: July 12, 2023

Attention: All Providers

Effective date: July 1, 2023

Call to action: The purpose of this communication is to provide awareness that the signature requirements for Title XIX (Medicaid) Home Health Services have changed. Medicaid-enrolled physicians and allowed practitioners can now sign prior authorizations and order covered Medicaid Home Health Services, including skilled nursing, home health aide services, durable medical equipment and supplies, and adult physical and occupational therapy services.

An allowed practitioner is a physician assistant (PA) or an advanced practice registered nurse who is licensed as a certified nurse practitioner (CNP) or clinical nurse specialist (CNS).

Background information: HHSC has recently adopted rules in alignment with 42 Code of Federal Regulations §440.70. Amendments to 1 Texas Administrative Code rules 354.1031, 354.1035, 354.1037, 354.1039, 354.1040, and 354.1043 bring Texas into compliance with the Centers for Medicare &

Medicaid Services CMS-5531-Interim Final Rule with Comment (IFC). The adopted rules for home health services became effective on September 21, 2022.

How this impacts providers: The new signature requirements should reduce the administrative burden regarding prior authorizations and orders for Medicaid covered services.

Next step for Providers: Providers should share this communication with their staff.

If you have any questions, please email Provider Relations at: providerrelations@texaschildrens.org.

For access to all provider alerts,log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.