MedicaidCoverageHigh impact
Baylor Scott & White and FirstCare Health Plans Will End Participation in Texas Medicaid Managed Care
Texas Medicaid·TX·General
Effective date
Sep 1, 2026
We identified it
Jul 18, 2026
Summary
Effective September 1, 2026, Baylor Scott & White and FirstCare health plans will terminate participation in Texas Medicaid managed care programs (STAR, CHIP). Billing teams must stop accepting claims with service dates on or after September 1, 2026, under these plans and ensure all claims with DOS on or before August 31, 2026, are submitted by the federal deadline of August 31, 2028.
Action Required
By August 31, 2026: Billing team must (1) Update billing system to reject all claims with DOS on or after September 1, 2026, for the following plan codes: 06 (FIRSTCARE CHIP Lubbock), 50 (FIRSTCARE STAR Lubbock), W4 (FIRSTCARE STAR MRSA West), C3 (S&W HP STAR MRSA Central); (2) Identify and submit all pending claims with DOS on or before August 31, 2026, to TMHP before the federal deadline of August 31, 2028; (3) Update eligibility verification systems to remove these plan codes effective September 1, 2026; (4) Notify all patient-facing staff that members on Baylor Scott & White and FirstCare plans must transition to newly selected health plans before September 1, 2026. Failure to submit claims by the deadline will result in permanent claim rejection. Contact TMHP at 800-925-9126 for member transition information.