Newborn Screening Benefits Program

Announcements

This page is intended to provide information to agencies that contract with the Texas Department of State Health Services to provide newborn screening benefits to eligible clients.

Below are the Provider Manual and a Summary of Changes.  Very few changes were made to the medication, vitamins and dietary supplements at this time.  Other revision may follow as needed.  Feel free to call Cathy LaCrosse at 512-776-2983 if you have any questions.

FY 2012 NBS Benefits Program Contractor Mannual

• 2012 MANUAL (PDF)
• 2012 SUMMARY OF CHANGES – SEPTEMBER 13, 2011 (PDF)

• NBS BENEFITS PROGRAM APPLICATION FOR SERVICES INSTRUCTIONS (Word)
• NBS BENEFITS PROGRAM APPLICATION FOR SERVICES (Word)
• STATEMENT OF APPLICANT’S RIGHTS AND RESPONSIBILITIES
• PRESCRIPTION FORM (Word)
• ADDITIONAL PRESCRIPTION REQUEST (Word)
• LOW PROTEIN FOOD REQUEST (Word)
• PRESUMPTIVE ELIGIBILITY INSTRUCTIONS(Word)
• PRESUMPTIVE ELIGIBILITY APPLICATION (Word)
• METABOLIC / IMMEDIATE MEDICAL NEED PRESCRIPTION REQUEST(Word)

FY 2012 Monthly Billing and Report Forms and Instructions

• STATE OF TEXAS PURCHASE VOUCHER AND INSTRUCTIONS
• NBS BENEFITS PROGRAM CLIENT PROCEDURE REPORT
• NBS BENEFITS PROGRAM PRODUCTIVITY REPORT

FY 2012 Optional Forms

• STATEMENT OF SELF-EMPLOYMENT INCOME(Word)
• EMPLOYMENT VERIFICATION (Word)
• REQUEST FOR INFORMATION (Word)

Eligibility requirements: Infants, Children & Adults; prioritized by need as funds are available:

• Income at or below 350% of Federal Poverty Income Level
• Diagnosed with disorder identified by Newborn Screening Program
• Bona fide resident of the State of Texas
• Annual recertification review
• Ineligibility for other programs providing the same services:
  • Medicaid recipients
  • Children with Special Health Care Needs (eligible if on waiting list)
  • Children’s Health Insurance program
  • CHIP Perinatal
  • Title V Genetic Services
  • Private Insurance

Provides:

• Dietary Supplements (metabolic foods, low-protein foods)
• Medications
• Vitamins
• Confirmatory testing, evaluation, and follow up care
• Reimbursement to specialists for Telephone Consults

Eligibility is determined by NBS Benefits 1-800-252-8023 ext. 2983

Eligible Providers:

• Medical Genetic Clinics
• Centers specializing in Metabolic, Endocrine and Hematological Disorders
• Medical Geneticists
• Laboratories that provide confirmatory testing
• Pharmacies that provide vitamins, medications, dietary supplements (metabolic foods)
• Low-protein food manufacturers

           
Benefits:

Presumptive Positive:
            Infant eligible for two months of formula immediately upon positive results, if eligible   
            Confirmatory testing

Confirmed Diagnosis: 
            Evaluation & Management
            Follow-up care, including laboratory testing
            Remediation services-prescribed dietary supplements, vitamins, &/or  
            medications, low-protein foods

Open Enrollment Information

NBS Benefits Q&A (PDF)