Certain health care professionals are now required by state law to inform mothers on Medicaid that their newborn children are automatically eligible for Medicaid, and the state has produced downloadable documents enabling that process.
House Bill 3940, one in a number of bills passed in the 2025 legislative session to address Medicaid concerns, calls for the notification in order to help mothers, fathers, and adult caregivers understand that Medicaid can cover care for the newborns during the critical first year of life. The law applies to health care professionals who provide prenatal care to a pregnant woman during gestation or at delivery.
“This has been something that has been asked for by health care professionals,” said Cynthia Peacock, MD, chair of the Texas Medical Association’s Committee on Medicaid, CHIP, and the Uninsured. “It creates less barriers for moms to get their children on to get coverage.”
She adds that the new requirement, which went into effect Jan. 1, will help more health care professionals, especially those who do not regularly work with Medicaid participants, be more informed about getting newborns coverage for their first few checkups after birth. That will also aid physicians and other health care professionals in securing the Medicaid payment they’re eligible to receive.
“It’s a win-win for physicians and for patients,” she said.
HB 3940 specifies that a mother must be informed her Medicaid identification number may be used on claims for services provided to her newborn child “until the child is enrolled in Medicaid and assigned a separate Medicaid identification number.”
The law also requires the Texas Health & Human Services Commission (HHSC) to annually share that information with managed care organizations and health care facilities (including hospitals) that regularly care for pregnant women and newborn children in Medicaid.
To help health care professionals meet their obligation, the Texas Department of State Health Services published a document available in English and Spanish.
Physicians must document that they provided this information in medical records, per the new law.
Last month, HHSC also updated two online publications geared toward new parents to incorporate new Medicaid information: “Information for Parents of Newborns” and “A Parent’s Guide to Raising Happy, Healthy Children.”
Check out TMA’s online resources on Medicaid and the Children’s Health Insurance Program. Contact the Physician Payment Resource Center with questions about medical records and claims.
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Phil West
Associate Editor
(512) 370-1394
phil.west[at]texmed[dot]org
Phil West is a writer and editor whose publications include the Los Angeles Times, Seattle Times, Austin American-Statesman, and San Antonio Express-News. He earned a BA in journalism from the University of Washington and an MFA from the University of Texas at Austin’s James A. Michener Center for Writers. He lives in Austin with his wife, children, and a trio of free-spirited dogs.