Texas Migrant Care Network Webcast On Provider Enrollment

Texas Migrant Texas Migrant Care NetworkCare Network

Jana Blasi, MPAffJana Blasi, MPAffDeputy DirectorDeputy Director

Texas Association of Community Health Texas Association of Community Health Centers, Inc.Centers, Inc.

BackgroundBackground

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

Too difficult for families to attempt to Too difficult for families to attempt to enroll in various state Medicaid enroll in various state Medicaid programs while they are temporarily programs while they are temporarily out-of-state for work.out-of-state for work.

Reciprocity agreements among various Reciprocity agreements among various states has been problematic for Texas.states has been problematic for Texas.


Texas began to explore portability model, Texas began to explore portability model, Texas Migrant Care Network (MCN), in Texas Migrant Care Network (MCN), in 1998.1998.

Focus on enrolling out-of-state providers Focus on enrolling out-of-state providers who provide care to Texas migrants into who provide care to Texas migrants into the Texas Medicaid Program.the Texas Medicaid Program.

Out-of-State providers could then bill Out-of-State providers could then bill Texas Medicaid for provision of care to Texas Medicaid for provision of care to Texas Medicaid clients while they work Texas Medicaid clients while they work out-of-state.out-of-state.


In late March 2008, Texas Medicaid In late March 2008, Texas Medicaid contacted TACHC to identify out-of-contacted TACHC to identify out-of-state providers, especially FQHCs, state providers, especially FQHCs, interested in enrolling in Texas interested in enrolling in Texas Medicaid to create Texas MCN. Medicaid to create Texas MCN.

Goal is to facilitate access to Goal is to facilitate access to medical, dental and behavioral medical, dental and behavioral health services covered in Texas health services covered in Texas Medicaid by migrant children.Medicaid by migrant children.

Texas Migrant Care Texas Migrant Care NetworkNetwork

Texas Medicaid Agency is willing to Texas Medicaid Agency is willing to facilitate and expedite enrollment of out-facilitate and expedite enrollment of out-of-state providers who traditionally serve of-state providers who traditionally serve Texas migrant families.Texas migrant families.

Focus of project is on migrant children Focus of project is on migrant children who are currently enrolled in Texas who are currently enrolled in Texas Children’s Medicaid.Children’s Medicaid.

An estimated 200,000 to 300,000 MSFWs An estimated 200,000 to 300,000 MSFWs reside in Texas (at least 100,000 are reside in Texas (at least 100,000 are children 0 – 19)children 0 – 19)


Currently, this program is limited to Currently, this program is limited to Medicaid and CHIP is NOT includedMedicaid and CHIP is NOT included

This is not an expansion of Texas This is not an expansion of Texas Medicaid and this program does not Medicaid and this program does not create a new eligibility category in Texas create a new eligibility category in Texas Medicaid.Medicaid.

MCN is only for migrant family members MCN is only for migrant family members who are enrolled in Texas Medicaid prior who are enrolled in Texas Medicaid prior to leaving Texas for out-of-state work.to leaving Texas for out-of-state work.

Texas Medicaid Eligibility Texas Medicaid Eligibility Levels and GroupsLevels and Groups

Texas Children’s Texas Children’s Medicaid Include:Medicaid Include:

Ages 0 to 1 up to Ages 0 to 1 up to 185 % of FPL185 % of FPL



Pregnant Women Pregnant Women up to 185 % of FPLup to 185 % of FPL

Women’s Health Women’s Health Program eligibility Program eligibility includes Women includes Women between the ages between the ages of 18 to 44 up to of 18 to 44 up to 185 % of FPL185 % of FPL


Targeting FQHCs to participate in Targeting FQHCs to participate in Texas MCN but other out-of-state Texas MCN but other out-of-state providers are also welcome to providers are also welcome to participate.participate.

State will pay FQHCs their PPS rate State will pay FQHCs their PPS rate and other providers will receive Fee-and other providers will receive Fee-For-Service Texas Medicaid Rates.For-Service Texas Medicaid Rates.

Challenges to Implementation

Identify and enroll eligible MSFW families into Texas Medicaid

Educate MSFW families to maintain their TX Medicaid coverage while out-of-state

Outreach and case management services to let them know about TX MCN and where providers are that accept TX Medicaid

Challenges to Implementation

Many MSFWs have already left the state

If any red flags on provider enrollment applications, could delay enrollment of providers into TX Medicaid

Billing issues related to MSFW “members” enrolled in Medicaid managed care rollout areas of the state

What TACHC is DoingWhat TACHC is Doing

TACHC is developing flyers targeting TACHC is developing flyers targeting migrant families and out-of-state migrant families and out-of-state providers to educate them about this providers to educate them about this program.program.

Web page on the Texas Migrant Care Web page on the Texas Migrant Care Network has been developed and will Network has been developed and will used as an additional resource of used as an additional resource of information for both migrant families, information for both migrant families, health care providers and advocateshealth care providers and advocates

Visit www.tachc.orgVisit www.tachc.org

What TACHC is Doing

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:- Provider Reimbursement- Billing- Provider Enrollment

What TACHC is Doing Providing staff to provide TA, training

and to troubleshoot issues with out-of-state providers enrolling into TX Medicaid

Working with the state to develop effective outreach strategies

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

What You Can DoWhat You Can Do

Help TACHC get the word out about Help TACHC get the word out about the Texas MCN to your state PCAthe Texas MCN to your state PCA

Get the word out to other FQHCs in Get the word out to other FQHCs in your state and other states that see a your state and other states that see a high volume of Texas migrant families.high volume of Texas migrant families.

Advise your Texas migrant families to Advise your Texas migrant families to enroll in Texas Medicaid and/or enroll in Texas Medicaid and/or maintain their Texas Medicaid maintain their Texas Medicaid coverage when they travel out-of-state.coverage when they travel out-of-state.


For More Information on Policy Issues For More Information on Policy Issues Contact:Contact:

Jana BlasiJana Blasi512.329.5959 or 512.329.5959 or [email protected]

Information on how to Enroll as a Provider Information on how to Enroll as a Provider in TX Medicaidin TX Medicaid

Contact:Contact:Veronica EscobarVeronica Escobar512.506.7380 or 512.506.7380 or

[email protected]

Health & Medicine

Texas Migrant Care Network Webcast On Provider Enrollment