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News and Updates

Prior Authorizations Update – Effective 10/1/2018

Notice to Physicians and Providers

Memorial Hermann Health Plan, Inc., 929 Gessner, Suite 1500, Houston, Texas 77024, which provides group health maintenance organization (HMO) plans for persons living or working in the greater Houston area, is accepting applications as of February 1 through February 28, 2018, from physicians and providers (ancillary or facility) wishing to join the network as a participating physician or provider (ancillary or facility). Please contact us at this email address to receive additional information about being a part of our HMO network:

Behavioral Health

Effective July 1, 2017, Memorial Hermann Health Plan (MHHP) will begin transitioning mental health and chemical dependency services to United Behavioral Health, operating under the brand Optum. Optum will be responsible for the professional provider and facility network, utilization management services and claims administration. Employer groups will transition to Optum on their renewal date. MHHP’s Medicare Advantage HMO and Medicare Advantage PPO plans will transition to Optum effective January 1, 2018. The behavioral health vendor information will be included on the member’s ID card for groups who have transitioned to Optum.

If you are interested in joining the United Behavioral Health network, please contact the United Behavioral Health Network Management Department at or 877-614-0484.

January 31, 2017 - Medicare Outpatient Observation Notice

On December 8, 2016, the Centers for Medicare & Medicaid Services (CMS) released the OMB-approved Medicare Outpatient Observation Notice (MOON). The MOON is mandated by the Federal Notice of Observation Treatment and Implication for Care Eligibility Act (NOTICE Act), passed on August 6, 2015. The MOON is a standardized, written notice explaining that a Medicare beneficiary, including a Medicare Advantage enrollee, is receiving outpatient observation services, and is not an inpatient.

The notice must include the reasons the individual is an outpatient receiving observation services and the implications of receiving such services. Hospitals and critical access hospitals (CAHs) must deliver the notice no later than 36 hours after initiation of observation services. All hospitals and CAHs are required to start providing this statutorily required notification no later than March 8, 2017. Medicare Outpatient Observation Notice and accompanying form instructions are available by clicking here.

September, 2015 - ICD-10 Transition

The transition to ICD-10 will be implemented on October 1, 2015. Please read this letter from CMS regarding the transition. You may also visit and the American Medical Association for more information on the transition.