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The Texas Health and Human Services Commission (HHSC) is an agency within the Texas Health and Human Services System. It was established by House Bill 2292 in 2003 during the 78th Legislature, [ 1 ] which consolidated twelve different healthcare agencies into five entities under the oversight of HHSC.
In the United States, Medicaid is a government program that provides health insurance for adults and children with limited income and resources. The program is partially funded and primarily managed by state governments, which also have wide latitude in determining eligibility and benefits, but the federal government sets baseline standards for state Medicaid programs and provides a ...
Additionally, since Medicaid benefits vary by state, it is difficult for care providers and consumers to understand the complexity that is inherent within the Medicaid system. Because duals tend to be the most vulnerable, and often sickest, adults, their care has historically been expensive, totaling $319.5 billion in 2011. [ 2 ]
Conflicting information, computer systems not working, denials before verification and more problems come to the surface from whistleblowers, advocacy groups.
Health information exchange (HIE) is the mobilization of health care information electronically across organizations within a region, community or hospital system. In the aggregate, participants in data exchange are called Health Information Networks (HIN).
Primary Care Case Management (PCCM) is a system of managed care in the US used by state Medicaid agencies, in which a primary care provider is responsible for approving and monitoring the care of enrolled Medicaid beneficiaries, typically for a small monthly case management fee in addition to fee-for-service reimbursement for treatment. [1]
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The Centers for Medicare & Medicaid Services (CMS) is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children's Health Insurance Program (CHIP), and health insurance portability standards.