Monthly Archives - April 2020

Provider Alert!
08Apr

Provider Alert! FDA removing all ranitidine products from the market

Attention: All Providers and Pharmacies Effective Date: April 2, 2020 Call to action: The FDA announced it is requesting manufacturers withdraw all prescription and over-the-counter (OTC) ranitidine drugs from the market immediately. This is the latest step in an ongoing investigation of a contaminant known as N-Nitrosodimethylamine (NDMA) in ranitidine medications (commonly known by the brand name Zantac). The agency has determined that the impurity in some ranitidine products increases over time and when stored at higher than room temperatures and may result in...

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08Apr

Provider Alert! Provider resources: Coronavirus Aid Relief and Economic Security (CARES) ACT and more

Attention: All Providers Effective Date: March 27, 2020 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated to the COVID-19 event.  TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event.\ Call to action: TCHP sincerely appreciates the care you and your staff deliver to our members and want you to know that we are here to provide guidance and support to you...

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07Apr

Provider Alert! COVID-19 Disaster Declaration – ALERT #3 – Prior Authorization Adjustments

Attention: All Providers Effective Date: April 3, 2020 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated to the COVID-19 event.  TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event.   Call to action: As are result of the COVID-19 Disaster Declaration, TCHP has instituted the following changes to our authorization procedures. This alert is an update to our alert on April 2, 2020...

By Facilities, OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , , , 0 CommentsRead more...
Provider Alert!
06Apr

Provider Alert! Attention: Early Childhood Intervention (ECI) Providers

Attention: Early Childhood Intervention (ECI) Providers Effective Date: April 3, 2020 Call to action: In accordance with guidance from Texas Medicaid Provider Procedures Manual (TMPPM), providers must use the associated benefit code when submitting claims. How this impacts providers: Changes in billing practices may be required if there are claim denials. Next steps for providers: Billing reminders: Providers should ensure that their claims submissions include their benefit code per TMHP guidelines. If the taxonomy code is attested to a benefit code, the benefit code should be...

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Provider Alert!
03Apr

Provider Alert! Patient Lifts

Attention: Primary Care and DME Providers Effective Date: July 3, 2020 Call to action: In accordance with Texas Medicaid Provider Procedure Manual (TMPPM), patient lifts will require prior authorization, except for E0637 & E0641when billed outside of the benefit limitations.  Click here for the Prior Authorization Form. Coding information for lifts as an addition to the mobility aids that are already on the Prior Authorization list. Code Explanation E0630* Hydraulic//mechanical lift. This code has a limit of 1 purchase every 5 years and 1 month rental. E0635* Portable lift....

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03Apr

Provider Alert! COVID-19 Guidance: UPDATE ALERT #5 Telehealth Services: Targeted Case Management through remote delivery

Attention: Behavioral Health, OB/GYN, and ECI Providers Effective Date: April 24, 2020 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated to the COVID-19 event.  TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event. Call to action:  TCHP supports Texas Medicaid Healthcare Partnership (TMHP) guidance on Targeted Case Management. This service may be delivered through synchronous audio-visual technologies or telephone (audio-only). Providers should...

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02Apr

Provider Alert! Pharmacy Updates Related to COVID-19

Attention: All Providers and Pharmacies Effective Date: March 20, 2020 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated to the COVID-19 event.  TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event. Call to action: Texas Children’s Health Plan (TCHP) supports member access to medications with guidance from Texas Health and Human Services Commission (HHSC) and Texas State Board of Pharmacy during...

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02Apr

Provider Alert! COVID-19 Disaster Declaration – ALERT #2 – Prior Authorization Adjustments

Attention: All Providers Effective Date: April 1, 2020 Providers should monitor the Texas Children’s Health Plan Provider Portal regularly for alerts and updates associated to the COVID-19 event.  TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event. Call to action: As are result of the COVID-19 Disaster Declaration, TCHP has instituted the following changes to our authorization procedures. This alert is an update to our alert on March 18, 2020 and...

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Provider Alert!
02Apr

Provider Alert! Therapeutic Continuous Glucose Monitors Become Benefit of Texas Medicaid

Attention: Primary Care Providers and Endocrinologists  Effective Date: April 1, 2020 Call to action: Texas Children’s Health Plan (TCHP) supports Texas Medicaid Health Partnership’s (TMHP) decision to include therapeutic continuous glucose monitors (CGM) as a benefit for Texas Medicaid recipients.  A therapeutic CGM device requires prior authorization and is used as a replacement for self-blood glucose monitoring (SBGM). Members who have Type I or Type II diabetes may be considered for therapeutic CGM. All of the following medical necessity criteria must be met. The...

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