Medicaid, Texas Health Steps and CHIP

What will you Learn? You will be able to locate information about the Medicaid program and the Texas Health- Steps Program and have a basic understanding of the programs. You will be able to locate information about CHIP and understand how it operates in Texas.

How Learning is Measured You will demonstrate competency by completing the Medicaid, Texas Health Steps and CHIP Website Information Quiz with 90% accuracy.

Medicaid and CHIP Medicaid and CHIP have income, residency and children’s citizenship or legal status requirements

Texas Health Steps The EPSDT service in Texas is known as Texas Health Steps – For Texas Health Steps provider information go to:

Comprehensive Care Program (CCP) Additional services for children are available through the Comprehensive Care Program (CCP).

ECI and Medicaid Over 60% of the children served by ECI are also Medicaid eligible. The ECI programs enroll as network providers with Medicaid Managed Care Organizations that serve the ECI program’s local service area.

ECI and Medicaid ECI services covered by Medicaid are:  Case Management services  Specialized Rehabilitative Services (Specialized Skills Training, Physical Therapy (PT), Occupational Therapy (OT) and Speech Therapy (ST))  Additional CCP services (such as PT, OT and ST evaluations and reevaluations, nutrition services and counseling services)

ECI and Medicaid Medicaid Administrative Claiming (MAC) Program The Random Moment Time Study

ECI and Medicaid Medicaid Buy-In program helps families who need health insurance but make too much money to qualify for traditional Medicaid. For more information, go to:

ECI and Medicaid Texas Medicaid Wellness Program Goal: To help clients with long-lasting or serious health conditions improve their health Eligibility: People who get traditional fee-for- service Medicaid can join the wellness program

ECI and Medicaid Providers include: nurses, pharmacists, social workers, behavioral health specialists, dieticians, certified diabetes educators and community health workers Wellness program nurse at (toll-free). The service is free. Medicaid-Wellness-Program.htmlhttp:// Medicaid-Wellness-Program.html

ECI and Medicaid Health Insurance Premium Payment (HIPP) Program reimburses Medicaid clients for the cost of medical insurance premiums.

ECI and Medicaid HIPP Program The HIPP Program clients access their benefits as Texas Medicaid fee-for-service clients and are not enrolled in managed care STAR Health program clients are not eligible to receive HIPP benefits

ECI and Medicaid Medical Transportation Program (MTP) MTP provides rides to the doctor or dentist’s office, hospital, drug store or any place where a child with Medicaid gets Medicaid services The parent must not have any other way to get the child to the appointment The appointment must be set before calling for a ride

ECI and Medicaid This link provides the phone numbers for contacting the Medical Transportation Program. The numbers are toll-free, and instructions for scheduling are also provided. dex.shtml#Get_Ride dex.shtml#Get_Ride etRide_FAQs.shtml etRide_FAQs.shtml

Medicaid, Texas Health Steps and CHIP Activity # 1 Read the information on the home page and on the link, “What is Medicaid?” at:

Medicaid, Texas Health Steps and CHIP Activity # 2 Read the Early & Periodic Screening & Diagnostic Treatment benefit and EPSDT Services information on the home page at: Information/By-Topics/Benefits/Early-Periodic- Screening-Diagnosis-and-Treatment.html Information/By-Topics/Benefits/Early-Periodic- Screening-Diagnosis-and-Treatment.html

Medicaid, Texas Health Steps and CHIP Activity # 3 Medicaid in Texas: Chapters 4.1 and 4.2 of the Early Childhood Intervention Reimbursement Guide posted under the Third Party Billing Document Library on the ECI Extranet For Texas Health Steps: and For training modules offered by Texas Health Steps:

Children’s Health Insurance Program CHIP provides coverage for children in families with incomes at or below 200 percent of the Federal Poverty Level (FPL), provided they are not eligible for Medicaid. To determine if a family may qualify for CHIP or Children’s Medicaid, go to:

ECI and CHIP CHIP in Texas: Chapters 4.1 and 4.2 of the Early Childhood Intervention Reimbursement Guide posted under the Third Party Billing Document Library on the ECI Extranet

Medicaid, Texas Health Steps and CHIP Activity # 4 Read the information on the home page and on the link, “What is CHIP?” at:

Working with Families enrolled in CHIP or Medicaid You play an important role in assisting families with enrolling in Medicaid/CHIP and accessing Medicaid and CHIP services available through the ECI program as well as outside the ECI program.

Quiz Medicaid, Texas Health Steps and CHIP Website Information Quiz

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