Superior HealthPlan Community Grant Program

Superior HealthPlan Community Grant Program is sponsored by Superior HealthPlan. Provides grants to Texas-based organizations addressing non-medical drivers of health, including food security and housing stability.

* Health Insurance Marketplace Plans * Medicare Advantage Plan * Find My Provider Representative * Network Request or Update * Provider News & Information * Supporting Texas Communities * Superior in the Community * Find Community Resources * Find Community Relations Representatives * Health Insurance Marketplace Plans * Medicaid and CHIP Events * Plan Benefits, Services & Co-Pays * Medicare Advantage Plan * Find My Provider Representative * Network Request or Update * Change of Ownership (CHOW) * Add a Practice Location to an Existing Contract * Add a Product to an Existing Contract * Add a Provider to an Existing Group Contract * Network Status Inquiry Form * Request Network Participation, Non-Contracted Providers Only * Ambetter Prior Authorization * Medicaid and CHIP Prior Authorization * Medicare Prior Authorization * Wellcare By Superior HealthPlan (AIP) * Quarterly Provider Meetings * Provider News & Information * Clinical, Payment & Pharmacy Policies * Durable Medical Equipment (DME) * Find My Provider Representative * Member Rights and Responsibilities * Patient Centered Medical Home Model * Updating Provider Demographic Information * The Importance of Interoperability * Provider Training Calendar * Behavioral Health Clinical Trainings * About Superior HealthPlan * Superior HealthPlan News * Authorization to Disclose * Effective March 1, 2024: Removal of Prior Authorization Requirement for Certain Genetic Procedures * Pneumococcal 20-Valent Conjugate Vaccine Age Range Expansion * Updated January 25,2024 : Texas Medicaid Preferred Drug List Updates * EVV Claims Matching Bypass from January 1 to March 31 * EVV Visit Maintenance Processes on Hold for Dates of Service Prior to Go-Live Date with Current EVV * Effective March 1, 2024: Pharmacy and Biopharmacy Policies * Apply Now: Home Health Aide Training Program * Now Available: HHSC Telemedicine and Telehealth Educational Video and Infographics * Test Page January 1, 2024 * 3 in 30 Assessments for Foster Care Patients * UPDATED: STAR Kids LTSS Billing Matrix * STAR Health Trauma-Informed Care Alternative Payment Model * ACTION REQUIRED: Rate Enhancement * Provider Satisfaction Survey Save the Date * Medicare Member Plan Benefits Resumed for Applicable COVID-19 Testing, Screening, and Treatment Services * Effective August 1, 2023: Pharmacy and Biopharmacy Policies * Medicaid Inpatient Hospital Spell of Illness Policy Extension for COVID-19 Ending * Superior HealthPlan, Pro Football Hall of Famer Darrell Green Help Make First Back-to-School Community Fair & Fest in Kingsville a Success * Upcoming Hepatitis C Educational Webinar for Prescribers * Upcoming EVV HHAeXchange Webinar * Effective May 1, 2024 Pharmacy and Biopharmacy Policies * Help Protect Your Patients and Your Community Against RSV * Provider Alert: Change Healthcare Cybersecurity Incident and Its Impact to Superior HealthPlan * Effective September 1, 2021: Benefit Changes to Total Disc Arthroplasty for Medicaid and CHIP * Effective July 15, 2021 through December 31, 2021: Temporary Relaxation of Prior Authorization Requirements for DME, Orthotic, and Enteral/Parenteral Nutrition and Medical Supplies * Javelina legend and NFL hall of famer Darrell Green gives back to Kingsville * Barrier Removal Fund (BRF) 2022 Initiative * Provider Notice of Adverse Benefit Determinations * Superior to Override Timely Filing for Claims Impacted by Texas Medicaid Healthcare Partnership’s (TMHP) Eligibility Verification Issues * Support for Superior HealthPlan Members Affected by Severe Weather, Wildfire, or Other Natural Disaster * Support for Superior Members Affected by Severe Weather, Wildfire, or Other Natural Disaster * Effective January 1, 2024: Retired Medicare Clinical and Clinical Payment Policies * Effective June 1, 2024: New Clinical Payment Policies: Infectious Disease - Lab Screening and Testing * Training Requirement: Model of Care * 3 in 30 Assessments for Foster Care Patients * STAR+PLUS: Contract Award Updates * EVV Claims Matching Resumes April 1, 2024; Unmatched EVV Claims will Deny for Payment * REQUIRED: After-Hours, Appointment and Office Site Standards * Availity to Host Live Training Webinars for Providers * IMPORTANT: Updates to HHAeXchange EVV Training Resources * Texas-based Superior HealthPlan Releases Annual Community Investment Report * Effective April 15, 2024: Cranial Molding Orthosis * Secure Portal: Manage Tasks Quickly and Easily * Effective March 25, 2024: Clinical Policies * Effective May 31, 2024: Clinical Policies * 2023 – 2024 Respiratory Syncytial Virus (RSV) Season Changes * Effective June 1, 2024: Pharmacy and Biopharmacy Policies * Effective April 1, 2024: Pharmacy and Biopharmacy Policies * EVV Visit Transaction Rejection Codes to Begin April 1, 2024 * members-rate-their-provider-experience-03262024 * REQUIRED: Prior Authorization for Nursing Facility Add-On Therapy * NOW AVAILABLE: HHS Briefing on Change Healthcare * Drug Take Back April 2024 * Health Passport Requirements for Behavioral Health Providers Serving STAR Health Members * April 27: Drug Take Back Day * Resolving Payment Discrepancies on Claims * Effective 04/22/24: Durable Medical Equipment, Prosthetics, Orthotics, and Medical Supplies Online Platform * NEW: Partnership and Appointment Platform with Grow Therapy * Access Behavioral Health Tools and Resources * Billing EVV Services as Secondary Insurance Claims * NEW: Change Healthcare Availity and Zelis Processes * Updated EVV Home Health Care Services Bill Codes Table * UPDATED: Timeframe for Clinical Information for Acute Inpatient Facility Providers * ACTION REQUIRED: CMS Annual Drug Utilization Review Survey for FFY 2023 * PROHIBITED: Balance Billing * Register for Upcoming LTSS Recruitment and Retention Webinar * Effective August 1, 2024: Prior Authorization for Certain Genetic Procedure Codes * Effective May 1, 2024: Pharmacy and Biopharmacy Policies * ACTION REQUIRED: Confirm Your Provider Information is Accurate * Attention: Providers in the Travis Service Delivery Area * Now Available: Trainings for Hospital Providers * EVV Alternative Device Phase-Out Schedule for Public Comment – Due by May 15 * Effective May 1, 2024: Removal of Prior Authorization Requirement for Certain Medical Eye Procedures * Updates to the EVV Visit Maintenance Processes Hold for Dates of Service Prior to Go-Live Date * AcariaHealth Remains In-Network and a Preferred Specialty Pharmacy * Effective July 1, 2024: Pharmacy and Biopharmacy Policies * Effective August 1, 2024: Clinical Policies * Do Your Patients Understand Their Rights and Responsibilities?

* Superior HealthPlan Employees Show Support for March of Dimes in Austin * Asthma Awareness Month: Inclusion of National Guidelines into Clinical Practice * Secure Portal: Manage Tasks Quickly and Easily * ATTENTION LTSS PROVIDERS: 2023 Cost Report Due to HHSC by 5/15 * Provider Credentialing Information and Rights * EVV Compliance Grace Period Extended * Effective August 1, 2024: Pharmacy and Biopharmacy Policies * Effective June 1, 2024: Pharmacy and Biopharmacy Policies * Effective May 22, 2024: Clinical Policies * Effective May 27, 2024: Clinical Policies * Effective June 28, 2024: Clinical Policies * Effective July 31, 2024: Clinical Policies * Effective June 1, 2024: Revised Payment Policy: Code Editing Overview * Ascension Cybersecurity Incident Provider Accommodations * Provider Training Opportunities and Special Events * EVV PSO 2024 Onboarding Schedule and Enrollment Information * IMPORTANT: Updates to the Provider Statement of Need Form * 3 in 30 Assessments for Foster Care Patients * HHSC STAR+PLUS Upcoming Webinars * June 13: Hepatitis C Webinar for Prescribers * Care Management: Helping Providers Assist Superior Members * Effective 9/1: STAR+PLUS Contract Changes * 2024 EVV Proprietary System Request Form Submission Deadline July 15, 2024 * Adding Behavioral Health Providers to Maternal Mental Health Treatment Network * Training Requirement: Model of Care * Effective July 1, 2024: Pharmacy and Biopharmacy Policies * Effective September 1, 2024: Pharmacy and Biopharmacy Policies * IMPORTANT: Billing Notice to Behavioral Health Providers * 2023 Cost Report Training Information for LTSS Providers * Effective October 1, 2024: Prior Authorization Update for New CPT Codes * Reminder: EVV Home Phone Landline Requirements * Effective June 1, 2024: Elimination of Certain Laboratory Services Payment Policies * Effective 10/1/24: Co-pays will Resume for CHIP COVID-19 Services * IMPORTANT: Medical Records Retrieval Project * Home Telemonitoring Services Adding Federally Qualified Health Centers and Rural Health Clinics * Important Cultural Competency, Health Equity and NMDOH Resources * REQUIRED: After-Hours, Appointment and Office Site Standards * Effective October 31, 2024: Clinical Policies * Effective September 30, 2024: Clinical Policies * Effective July 22, 2024: Clinical Policies * Effective October 1, 2024: Pharmacy and Biopharmacy Policies * Upcoming LTSS Recruitment and Retention Webinar * Provider Satisfaction Survey * Upcoming Provider Satisfaction Survey * EVV Policy Reminder for Severe Weather * Effective 9/1/24: Procedure Code Update for Dental Anesthesia Prior Authorization Requests * Additional 2023 CPC Cost Report Training Information for LTSS Providers * Effective 10/31/24: Behavioral Health – Substance Use Disorder Treatment Criteria * Effective 7/25/24: Texas Medicaid Preferred Drug List Updates * Effective November 11, 2024: Clinical Policies * New and Revised Clinical Payment Policies and Code Editing Payment Policy Reminder for Marketplace * Requirements for Claim Submissions * NEW: Provider Tool for Enhancing Care for those with IDD and Communication Barriers * Effective 9/1/24: Genetic Services Biomarker Testing * Tips for your Practice: Chlamydia Screening Recommendations * Healthcare Resources and Alternatives to Use in Your Practice * Effective September 1, 2024: Pharmacy and Biopharmacy Policies * Effective November 1, 2024: Pharmacy and Biopharmacy Policies * ACTION REQUIRED: Rate Enhancement Affidavit * IMPORTANT INFORMATION: For Providers in the Bexar SDA * Effective 9/1/24: Influenza Vaccine Procedure Code Becomes a Benefit of Texas Medicaid * Improving Health through Quality Improvement * Clarification: Lumbar Sacral Orthotics Criteria * Effective 10/1/24: COVID-19 Vaccine Administration Updates for Medicaid and CHIP * IMPORTANT: STAR+PLUS Authorization for Services that Require the Use of EVV * IMPORTANT: CDI Upcoming Webinars * Support for Superior HealthPlan Members Affected by Severe Weather, Wildfire, or Other Natural Disaster * REMINDER: Updated TAC References in CDS Forms * HHSC REMINDER: Postpartum Medicaid and CHIP Coverage Extension * Effective December 1, 2024: Pharmacy and Biopharmacy Policies * Effective December 1, 2024: Pharmacy and Biopharmacy Policies * Resource for Members: Pyx Health * REGISTER NOW: In-Person Trauma-Focused Cognitive Behavioral Therapy Training * Effective 9/1: STAR+PLUS MCO-to-MCO Transfer of Authorizations * Effective September 23, 2024: Clinical Policies * Effective 10/01/24: RSV Vaccine Procedure Code 90683 Becomes a Benefit of Texas Medicaid * EVV Compliance Grace Period Ends December 31 * NEW: HHSC EVV Policy Handbook Revisions * 2024-2025 RSV and Synagis® Season Prior Authorization * Effective November 1, 2024: Pharmacy and Biopharmacy Policies * Effective January 1, 2025: Pharmacy and Biopharmacy Policies * Update to Unit Limitations for Certain Medical Supplies * Effective February 1, 2025: Clinical Policies * EVV Alternative Device Reduction Schedule * COPD Awareness Month: Tips, Tools, and Resources * Reminder: Medicaid Third Party Liability Provider Requirements * REQUIRED: Adult Foster Care Residential Agreement Checklist * Effective 12/27/24: OnTrak Partnership Ends * Effective December 1, 2024: Pharmacy and Biopharmacy Policies * Effective November 25, 2024: Clinical Policies * Effective January 31, 2025: Clinical Policies * Effective 12/1/24: Certain Non-Surgical Services Procedure Codes Updates * Training Requirement: Model of Care * REMINDER: EVV Compliance Grace Period Ends December 31 * EVV PSO ORR Sessions Updates * Effective September 1, 2024: Pharmacy and Biopharmacy Policies * Effective October 1, 2024: Pharmacy and Biopharmacy Policies * IMPORTANT: HHSC Medicaid Provider Enrollment Revalidation Flexibilities * Effective January 1, 2025: Pharmacy and Biopharmacy Policies * Effective March 1, 2025: Pharmacy and Biopharmacy Policies * Payment Policy Posting and Updates * Effective April 1, 2025: Sleep Studies Clinical Policies * Effective March 31, 2025: New and Revised Clinical Payment Policies * Notice to Physicians and Providers * Effective 1/30/2025: Texas Medicaid Preferred Drug List Updates * 2024 Cost Report Training Information for LTSS Providers * Support for Superior HealthPlan Members Affected by Severe Weather, Wildfire, or Other Natural Disaster * IMPORTANT: Post-Service Medical Necessity Appeal Submissions * 2025 Medicare and MMP Formulary Changes * Same-Day Texas CANS 3.

0 Assessments and Psychological and Neuropsychological Testing for STAR Health * Medicare Prescription Payment Program * Effective April 30, 2025: Clinical Policies * Effective January 27, 2025: Clinical Policies * Effective March 31, 2025: Clinical Policies * Effective April 20, 2025: Clinical Policies * Effective April 20, 2025: Concert Genetic Testing Policies * Superior HealthPlan Recognized as a Best Place for Working Parents® in Texas * Effective 4/1/25: HHSC Revisions to the Uniform Opioid Policy * Effective May 1, 2025: Pharmacy and Biopharmacy Policies * Effective March 1, 2025: Pharmacy and Biopharmacy Policies * Effective May 1, 2025: Pharmacy and Biopharmacy Policies * Support for Superior HealthPlan Members Affected by Severe Weather, Wildfire, or Other Natural Disaster * Effective March 1, 2025: New Medicaid Benefit - Certified Family Partner Services * Important Resource for Hospital Providers * Effective April 7, 2025: Pharmacy Coverage Updates for COVID-19 Test Kits and Vaccines * 3/12/25 UPDATE: HHSC EVV Policy Handbook Revisions * Important Resources for Providers * Effective June 1, 2025: Pharmacy and Biopharmacy Policies * Effective April 1, 2025: Pharmacy and Biopharmacy Policies * Effective April 1, 2025: Removal of Prior Authorization Requirement for Certain Sleep Studies * Members Rate Their Provider Experience * Effective March 31, 2025: Clinical Policies * Effective May 30, 2025: Clinical Policies * Tango-WellSky Partnership with Centene to Support Medicare Members * Effective July 1, 2025: Changes to Prior Authorization Requirements for Cardiology Services and Procedures * Cardiology Procedures: Transition of Utilization Review from TurningPoint to Evolent Effective for Service Dates beginning July 1, 2025 * Important Notice: Enforcement of Claim Filing Guidelines * Effective July 1, 2025: New Payment Policy: Inpatient Claim Billing/Coding Reviews * Upcoming Provider Satisfaction Survey * Coming Soon: PEMS Update to Allow Provider Credentialing * Effective July 1, 2025: Revised Payment Policy: Genetic and Molecular Testing Services * Effective May 1, 2025: Pharmacy and Biopharmacy Policies * Effective July 1, 2025: Pharmacy and Biopharmacy Policies * REQUIRED: 2024 Cost Reports for LTSS Providers * Effective August 1, 2025: New Prior Authorization Requirement for Certain Neurostimulators * Effective August 1, 2025: Clinical Policies * Effective August 1, 2025: Genetic Testing PLA Expansion * LTCOP Transitioning from RUG to PDPM LTC for Nursing Facilities * Effective July 15, 2025: Pharmacy and Biopharmacy Policies * Effective July 31, 2025: Clinical Policies * POSTPONED: Update to Allow Submission of Provider Credentialing Applications through HHSC’s PEMS for Medicaid and CHIP * Reminder: Tango-WellSky Partnership with Centene to Support Medicare Members * Change in Preferred Drug List Status for Glucocorticoids - Inhaled Drug Class Began on May 6, 2025 * Effective May 20, 2025: Clinical Policies * Now Available: HHAeXchange EVV System Survey * Separate Reimbursement of Certain Inpatient High-Cost Drug and Biologics * IMPORTANT NOTICE: Rider 32 Implementation Information * Effective June 1, 2025: Pharmacy and Biopharmacy Policies * Effective August 1, 2025: Pharmacy and Biopharmacy Policies * Superior HealthPlan Awards $200,000 in Grants to 20 Community-Based Organizations and Providers * Effective June 30, 2025: Superior HealthPlan to Discontinue Tomorrow Health DME-POS Pilot Program for Members in Bexar Service Delivery Area * ATTENTION SUPERIOR HEALTHPLAN PROVIDERS: * REMINDER: Ambetter Health Solutions Now Available * NEW RESOURCE: Quality Rating System (QRS) Behavioral Health Measure Toolkit * IMPORTANT: MHTCM and MHR Services Provider Attestation Requirements for State Fiscal Year 2026 * Apply Now: Home Health Aide Training Program for STAR+PLUS Providers * IMPORTANT: Update on ELEVIDYS for Non-Ambulatory Clients * Effective July 1, 2025: Pharmacy and Biopharmacy Policies * Effective September 1, 2025: Pharmacy and Biopharmacy Policies * UPDATED NOTICE: Rider 32 Implementation Information * Effective September 30, 2025: New Prior Authorization Requirement for Certain Bathroom Commode Chairs * Effective October 1, 2025: New Prior Authorization Requirement for Certain Genetic and Molecular Testing * Effective October 1, 2025: New Prior Authorization Requirement for Certain Chronic Wound Skin and Soft Tissue Substitutes * Important Reminders for HHAeXchange Customer Support Requests * Support for Superior Members Affected by Severe Weather * Clarification: Sleep Study Procedures for Members 17 Years of Age and Younger * REGISTER NOW: In-Person Trauma-Focused Cognitive Behavioral Therapy * Effective 7/28/2025: Texas Medicaid Preferred Drug List Updates * Rider 32 Implementation Reminder * Essential Tools and Resources for Comprehensive, Patient-Centered Care * IMPORTANT: Compliance with U.S.-Only Performance and Data Handling Requirements * Effective September 15, 2025: Clinical Policies * Effective August 1, 2025: Removal of Prior Authorization Requirement for Certain Genetic and Molecular Testing * Effective August 1, 2025: Pharmacy and Biopharmacy Policies * Effective October 1, 2025: Pharmacy and Biopharmacy Policies * Effective October 1, 2025: New Prior Authorization Requirement for Certain Genetic and Molecular Testing * Pharmacy Benefit Updates Related to July 2025 Hill Country and Central Texas Flooding * Effective July 31, 2025: Clinical Policies * REQUIRED: Nursing Facility Liability Insurance Rate Add-on Provider Attestation Due by July 31 * Effective September 1, 2025: HHSC Discontinuation of Attendant Compensation Rate Enhancement * Effective September 1, 2025: Change in Rate Methodology to Patient Driven Payment Model Long-Term Care for Assisted Living Facility Providers * Effective October 31, 2025: Clinical Policies * Superior HealthPlan Invests $18 Million in Over-the-counter Items in 5 Years for Texas Members * Effective August 11: New Availity Webinar Sessions * NEW: Behavioral Health Follow-Up Measures Tip Sheet * Effective October 15, 2025: Transition of Utilization Review for Automatic External Defibrillator * Updates Regarding 2025-2026 Respiratory Syncytial Virus (RSV) Ordering * Register Now: Equip Advancing & Uniting the Eating Disorder Conversation * Effective November 1, 2025: Pharmacy and Biopharmacy Policies * Effective August 1, 2025: Pharmacy and Biopharmacy Policies * Effective September 1, 2025: EVV Standalone Alternative Device Policy * 2025 Texas Flooding: Appeal and Continuation of Benefit Request Extensions * ATTENTION: Behavioral Health Partial Hospitalization Program and Intensive Outpatient Program Billing Code Update * IMPORTANT: Authorization Extensions Available for Texas Medicaid/CHIP Enrolled Flood Victims through 09/29/25 * System Upgrade and Outage Scheduled for October 10, 2025 * Effective November 30, 2025: Clinical Policies * Effective December 31, 2025: Clinical Policies * Effective October 31, 2025: Clinical Policies * Effective October 1, 2025: Pharmacy and Biopharmacy Policies * Effective December 1, 2025: Pharmacy and Biopharmacy Policies * 2025-2026 FDA-Approved Flu Treatment Options * Effective September 30, 2025: Clinical Policies * IMPORTANT: Sending Authorization Forms to the Correct Fax Number Based on Member Insurance * Effective January 1, 2026: New Payment Policy: Newborn Inpatient Stays * Effective November 1, 2025: Clinical Policies – Private Duty Nursing * Effective November 1, 2025: Private Duty Nursing Modifiers * Effective November 1, 2025: Pharmacy and Biopharmacy Policies * Effective January 1, 2026: Pharmacy and Biopharmacy Policies * Discontinuance of HCPCS Bundle Code 80050: Effective 1/1/26 * Upcoming HHAeXchange Webinars * HHSC Notice: Register for an Annual EVV Policy Training Webinar * Medicare Telehealth Coverage * Effective February 1, 2026: Revised Payment Policy: Leveling of Care: Emergency Department Evaluation and Management Over-coding for Professional Services * Effective February 1, 2026: Revised Payment Policy: Leveling of Care: Office-Based Evaluation and Management Over-coding * Effective 11/1/25: Modifiers Added to LTSS Authorizations * IMPORTANT: Pharmacy Resources Available to Providers * Effective February 9, 2026: Clinical Policies * Effective December 8, 2025: Bariatric Surgical Procedures * DME Attestation Requirement for Ordering Physicians * Effective December 1, 2025: Pharmacy and Biopharmacy Policies * Effective February 1, 2026: Pharmacy and Biopharmacy Policies * Effective November 26, 2025: Clinical Policies * Effective January 30, 2026: Clinical Policies * Effective December 31, 2025: Clinical Policies * Developmental Screening in the First Three Years of Life (DEV) Measure * Effective February 27, 2026: New Prior Authorization Requirement for Certain New Procedure Codes * Effective January 1, 2026: EVV Impacts due to Discontinued Dual Demonstration Pilot Program * Upcoming Live Availity Training for Doula Providers * 3 in 30 Assessments for Foster Care Patients * COPD Awareness Month: Tips, Tools, and Resources * 2026 EVV PSO Onboarding Schedule is Now Available * Effective January 1, 2026: Removal of Prior Authorization Requirement for Certain Procedures * COVID-19 Vaccine Availability Information * Effective March 1, 2026: New Clinical Policy for Mental Health Rehabilitative Services and Mental Health Targeted Case Management * NEW: Provider Representative Contact Form and Network Status Inquiry Form * Effective 3/1/26: New Prior Authorization Requirement for MHR/MHTCM Services * Prior Authorization Requirements for Joint Injections and Trigger Point Injections * Rider 32 – Continuity of Care * Effective March 1, 2025: Pharmacy and Biopharmacy Policies * Effective January 1, 2026: Pharmacy and Biopharmacy Policies * Effective 4/1/26: New Prior Authorization Requirement for Certain Procedure Codes * 4/1/26: Important Wellcare Prior Authorization Updates * 2026 MHR/TCM Provider Center of Excellence Application Process * HCPCS Annual Update Coming January 2026 * Providers Required to Distribute Newborn Medicaid Coverage Information * Notice to Physicians and Providers * End-Stage Renal Disease Eligibility and Evidence Report * Effective April 8, 2026: Clinical Policies * REQUIRED: Is Your Practice Information Accurate?

* Training Requirement: Model of Care * Effective April 20, 2026: Clinical Policies * Effective February 1, 2026: Pharmacy and Biopharmacy Policies * Effective January 30, 2026: Clinical Policies * Effective March 31, 2026: Clinical Policies * HHSC Currently Seeking Members for Three Advisory Committees * Health Passport Requirements for Behavioral Health Providers Serving STAR Health Members * Effective April 1, 2026: Clinical Polices * Effective 3/31/26: New Prior Authorization Requirement for Certain Neurostimulators * Effective 1/30/2026: Texas Medicaid Preferred Drug List Updates * IMPORTANT: Medical Records Retrieval Project * Superior HealthPlan Publishes 2025 Community Investment Report * NOTICE: Medicaid and CHIP Providers Billing Laboratory Services Subject to CLIA Certification Requirements * IMPORTANT: Provider Engagement Phone Decommission * IMPORTANT: PCP Change Requests * Members Rate Their Provider Experience * Upcoming Provider Satisfaction Survey * Effective April 1, 2026: Removal of Prior Authorization Requirement for Certain Procedures * Effective March 1, 2026: Pharmacy and Biopharmacy Policies * Preferred Provider for Incontinence Supplies * 3 in 30 Assessments for Foster Care Patients * IMPORTANT: Pharmacy Resources Available to Providers * Accuracy Matters: Is Your Info Up-to-Date?

* April 25: Drug Take-Back Day * Access Behavioral Health Tools and Resources * Effective June 1, 2026: Pharmacy and Biopharmacy Policies * Effective April 1, 2026: Pharmacy and Biopharmacy Policies * Effective March 31, 2026: Clinical Policies * Effective May 29, 2026: Clinical Policies * Effective for April 1, 2026 Dates of Service: Removal of Prior Authorization Requirement for Certain Interventional Cardiology and Diagnostic and Cardiac Radiology Procedures * REMINDER: STAR Health Trauma-Informed Care Alternative Payment Model * Effective 4/1/26: Authorization Requirements for Medicaid and CHIP Coordination of Benefits Claims * Effective 8/1/26: New Prior Authorization Requirement for Speech Therapy Evaluations * Effective 7/1/26: Change in the Utilization Review Agent for Physical, Occupational and Speech Therapy Services for STAR, STAR+PLUS and CHIP members * REQUIRED: After-Hours, Appointment and Office Site Standards * Effective 07/01/26: New Prior Authorization Requirement for Mandibular Advancement Device * New Login Process Through TMHP IAMOnline and Provider MFA Registration * New Payment Policy: Leveling of Care: Emergency Department Evaluation and Management Over-coding for Professional Services * Revised Implementation Date: New Payment Policy - Leveling of Care: Emergency Department Evaluation and Management Over-coding for Professional Services * Revised Implementation Date: New Payment Policy: Leveling of Care: Office-Based Evaluation and Management Over-coding * New Payment Policy: Leveling of Care: Office-Based Evaluation and Management Over-coding * Prohibited: Balance Billing * UPDATED: Timeframe for Clinical Information for Acute Inpatient Facility Providers * Effective May 1, 2026: Pharmacy and Biopharmacy Policies * Texas Medicaid Formulary Update: Xifaxan (rifaximin) Removal * IMPORTANT: MHR and MHTCM Services Provider Attestation Requirements for State Fiscal Year 2027 * Do Your Patients Understand Their Rights and Responsibilities?

* Action Requested: 2026 Texas PMP Prescriber Survey * Requirements for Claim Submissions * 2026 Annual HCPCS Update: Impacted Oncology Radiation Treatment Procedure Codes * New Login Process Through TMHPs IAMOnline and Provider MFA Registration for Release 1 Transition * IMPORTANT NOTICE: Medicaid and CHIP Program Provider Enrollment Revalidation * Important Credentialing Information for Providers * Care Management: Helping Providers Assist Superior Members * HHSC Uniform Opioid Policy Standards * NEW: The Importance of Interoperability * Effective May 29, 2026: Clinical Policies * Effective June 30, 2026: Clinical Policies * Effective July 31, 2026: Clinical Policies * Effective June 1, 2026: Pharmacy and Biopharmacy Policies * Effective August 20, 2026: Clinical Policies * Effective September 1, 2026: Pharmacy and Biopharmacy Policies * UPDATE: Claim Denial Suspense for CLIA Certification Information in the HHSC PEMS * Effective 07/31/26: Criteria Change for Disc Decompression Procedures * Effective 06/30/26: Criteria Change for Cochlear Replacement and Repair Requests * Reminder: Annual Provider Satisfaction Survey * New Login Process Through TMHP IAMOnline and Provider MFA Registration for Transition Release 2 * Early Detection and Prevention Guidelines for Cervical Cancer * CDS Forms Now Available on Provider Portal * New Payment Policy Effective August 1, 2026 - Intraoperative Neurophysiology Monitoring (IONM) * New Clinical Payment Policy Effective September 1, 2026 - Drugs of Abuse: Definitive Testing for more than 14 Drugs/Drug Classes * (Webinar) Wellcare By Allwell (Medicare Advantage) * (Webinar) Cultural Competency and Disability Sensitivity Training * (Webinar) STAR/CHIP/STAR+PLUS * (Webinar) STAR Kids Long-Term Service and Supports (LTSS) Billing Clinic * (Webinar) Hospital Provider Training * (Webinar) Hospital Flash Trainings-Medical Necessity Appeals * (Webinar) Hospital Flash Trainings-Prior Authorization Submissions * (Webinar) Meet WellCare * (Webinar) Hospitals Flash Trainings-Superior's Secure Portal-Locating an EOP * (Webinar) Hospital Flash Trainings-Prior Authorization Submissions * (Webinar) Meet WellCare * (Webinar) Hospital Provider Training * (Webinar) Hospital Flash Trainings-Prior Authorization Submissions * (Webinar) Hospital Flash Trainings-Medical Necessity Appeals * (Webinar) Hospitals Flash Trainings-Superior's Secure Portal-Locating an EOP * (Webinar) Meet WellCare * (Webinar) Hospital Provider Training * (Webinar) MHRTCM Program Training * (Webinar) MHRTCM Annual Attestation Packet Training * (Webinar) Health Passport (STAR Health) * (Webinar) Secure Provider Portal Training * (In Person) Bexar: Provider Advisory Group * Statewide: Clinical and Administrative Advisory Committee * (Webinar) Ambetter from Superior HealthPlan * (Webinar) Behavioral Health Billing Clinic * (Webinar) Comprehensive Billing Clinic * (Webinar) Electronic Visit Verification (EVV) * (Webinar) Cultural Competency and Disability Sensitivity Training * (Webinar) Wellcare By Superior HealthPlan (FIDE SNP) * (Webinar) Superior Nursing Facility Training * (Webinar) Wellcare By Allwell (Medicare Advantage) * (Webinar) STAR/CHIP/STAR+PLUS * (In Person) Hidalgo: Provider Advisory Group * (In Person) Nueces: Provider Advisory Group * (Webinar) Central: Provider Advisory Group * (In Person) Travis: Provider Advisory Group * (In Person) Northeast: Provider Advisory Group * (In Person) Dallas: Provider Advisory Group * (Webinar) MHRTCM Program Training * (Webinar) MHRTCM Program Training * (Webinar) MHRTCM Program Training * Notice of Privacy Practices * Supporting Texas Communities * Superior in the Community * Find Community Resources * Find Community Relations Representatives * Find Community Relations Reps * Health Insurance Marketplace Plans * Medicaid and CHIP Events * Plan Benefits, Services & Co-Pays * Medicare Advantage Plan * Find My Provider Representative * Network Request or Update * Change of Ownership (CHOW) * Add a Practice Location to an Existing Contract * Add a Product to an Existing Contract * Add a Provider to an Existing Group Contract * Network Status Inquiry Form * Request Network Participation, Non-Contracted Providers Only * Ambetter Prior Authorization * Medicaid and CHIP Prior Authorization * Medicare Prior Authorization * Wellcare By Superior HealthPlan (AIP) * Quarterly Provider Meetings * Provider News & Information * Clinical, Payment & Pharmacy Policies * Durable Medical Equipment (DME) * Find My Provider Representative * Member Rights and Responsibilities * Patient Centered Medical Home Model * Updating Provider Demographic Information * The Importance of Interoperability * Provider Training Calendar * Behavioral Health Clinical Trainings * About Superior HealthPlan * Superior HealthPlan News * Authorization to Disclose * Effective March 1, 2024: Removal of Prior Authorization Requirement for Certain Genetic Procedures * Pneumococcal 20-Valent Conjugate Vaccine Age Range Expansion * Updated January 25,2024 : Texas Medicaid Preferred Drug List Updates * EVV Claims Matching Bypass from January 1 to March 31 * EVV Visit Maintenance Processes on Hold for Dates of Service Prior to Go-Live Date with Current EVV * Effective March 1, 2024: Pharmacy and Biopharmacy Policies * Apply Now: Home Health Aide Training Program * Now Available: HHSC Telemedicine and Telehealth Educational Video and Infographics * Test Page January 1, 2024 * 3 in 30 Assessments for Foster Care Patients * UPDATED: STAR Kids LTSS Billing Matrix * STAR Health Trauma-Informed Care Alternative Payment Model * ACTION REQUIRED: Rate Enhancement * Provider Satisfaction Survey Save the Date * Medicare Member Plan Benefits Resumed for Applicable COVID-19 Testing, Screening, and Treatment Services * Effective August 1, 2023: Pharmacy and Biopharmacy Policies * Medicaid Inpatient Hospital Spell of Illness Policy Extension for COVID-19 Ending * Superior HealthPlan, Pro Football Hall of Famer Darrell Green Help Make First Back-to-School Community Fair & Fest in Kingsville a Success * Upcoming Hepatitis C Educational Webinar for Prescribers * Upcoming EVV HHAeXchange Webinar * Effective May 1, 2024 Pharmacy and Biopharmacy Policies * Help Protect Your Patients and Your Community Against RSV * Provider Alert: Change Healthcare Cybersecurity Incident and Its Impact to Superior HealthPlan * Effective September 1, 2021: Benefit Changes to Total Disc Arthroplasty for Medicaid and CHIP * Effective July 15, 2021 through December 31, 2021: Temporary Relaxation of Prior Authorization Requirements for DME, Orthotic, and Enteral/Parenteral Nutrition and Medical Supplies * Javelina legend and NFL hall of famer Darrell Green gives back to Kingsville * Barrier Removal Fund (BRF) 2022 Initiative * Provider Notice of Adverse Benefit Determinations * Superior to Override Timely Filing for Claims Impacted by Texas Medicaid Healthcare Partnership’s (TMHP) Eligibility Verification Issues * Support for Superior HealthPlan Members Affected by Severe Weather, Wildfire, or Other Natural Disaster * Support for Superior Members Affected by Severe Weather, Wildfire, or Other Natural Disaster * Effective January 1, 2024: Retired Medicare Clinical and Clinical Payment Policies * Effective June 1, 2024: New Clinical Payment Policies: Infectious Disease - Lab Screening and Testing * Training Requirement: Model of Care * 3 in 30 Assessments for Foster Care Patients * STAR+PLUS: Contract Award Updates * EVV Claims Matching Resumes April 1, 2024; Unmatched EVV Claims will Deny for Payment * REQUIRED: After-Hours, Appointment and Office Site Standards * Availity to Host Live Training Webinars for Providers * IMPORTANT: Updates to HHAeXchange EVV Training Resources * Texas-based Superior HealthPlan Releases Annual Community Investment Report * Effective April 15, 2024: Cranial Molding Orthosis * Secure Portal: Manage Tasks Quickly and Easily * Effective March 25, 2024: Clinical Policies * Effective May 31, 2024: Clinical Policies