HHSC grants grace period for new MRI policy

On May 1, 2006, the Texas Health and Human Services Commission instituted a new policy that requires prior authorization for MRIs and other imaging services for Medicaid or Medicaid PCCM patients. Concerns about the extra burden to hospitals and physicians were immediately raised by several top medical organizations.

In response, HHSC has agreed to implement a 30-day grace period to last from May 1 to May 31 during which claims will continue to be paid regardless of prior authorization by a physician. HHSC will also not enforce the 2-day notification period for retroactive authorization of emergency services provided in a physician’s office or outpatient setting.

HHSC will use the grace period to hold meetings with the Texas Medical Association, the Texas Hospital Association, the Office of the Inspector General, MedSolutions and other concerned parties. Physicians are encouraged to begin using the new practices to acquaint themselves and their staffs to the policy.

Find more information on authorization details and procedure codes from the “Prior Authorization for Radiology Services."