AUSTIN — Last week, Governor Greg Abbott announced that the Texas Health and Human Services Commission had submitted a Section 1135 Medicaid Waiver to the Center for Medicare and Medicaid Services (CMS). Approval of this waiver would grant the needed flexibility for the Medicaid program in response to the COVID-19 viral pandemic.

“Targeted initiatives to increase healthcare access to those most in need, as well as direct government funding of clinics that provide care for vulnerable populations would be optimal pathways for the flexibility in the waiver, if granted by CMS,” said David Balat, director of the Right on Healthcare initiative at the Texas Public Policy Foundation.

According to the announcement, the federal flexibilities (if approved) would include:

  • Temporarily extending existing prior authorizations for services so that Texans can get the care they need without delay.
  • Extending deadlines for state fair hearings and appeals.
  • Allowing services to be performed by telehealth, telemedicine, or telephonic contact.
  • Extending current medical necessity, service authorizations, and level of care authorizations for Medicaid programs.
  • Allowing the state to waive any requirements that require the signature of a physician, durable medical equipment provider, or Medicaid recipient.
  • Streamlining provider enrollment for out-of-state and new providers to increase the number of providers in Texas, which will ensure continued access to care.
  • Waiving requirements that health care professionals be licensed in the state in which they are providing services, so long as they have equivalent licensing in another state.

If granted, this Section 1135 Medicaid waiver flexibilities would remain in place for as long as necessary during the public health emergency. The Texas Public Policy Foundation is hopeful that these and other regulations that have been loosened or suspended will be made permanent by the legislature for the betterment of the doctor/patient relationship.