December 22, 2022

On December 19, 2022, we published an article announcing the end date for member appeals as January 31, 2023. The Texas Health and Human Services Commission (HHSC) has extended the end date to March 31, 2023.

Background

In January 2020, the federal government declared a public health emergency (PHE) in response to COVID-19. Under the PHE, the Texas Health and Human Services Commission (HHSC) has provided certain flexibilities, including allowing managed care members more time to request an appeal. Instead of the required 60 days, members were given 90 days to request an appeal during the PHE.  

What’s Changing

HHSC will be ending this flexibility on March 31, 2023.

Requirement

Starting April 1, 2023, if you receive an “Adverse Benefit Determination” notice and want to appeal it, you must file your appeal within 60 days of the date the notice is mailed. Appeals filed past this deadline may not be reviewed.

Questions

If you have any questions, please reach out to your health plan representative:

• Contact your BCBSTX Medicaid Network Team at 1-855-212-1615
• Submit via email Texas Medicaid Network Department