Monthly Archives - June 2020

Provider Alert!

Provider Alert! Nitrofurantoin Oral Suspension Drug Shortage

Attention: All Providers and Pharmacies Effective Date: June 12, 2020 Call to action: Drug shortages of nitrofurantoin oral suspension have been identified on the Medicaid and CHIP formularies.  There is only one National Drug Code (NDC) available on the market, and it is not on the Medicaid formulary. There are many other antibiotic choices available on the formulary and prescribers may choose an appropriate alternative based on patient diagnosis and indication for use. How this impacts providers:  Members may reach out to providers...

Provider Alert!

Provider Alert! Texas Medical Board Emergency Rule re: Issuance of Prescriptions During COVID-19 Pandemic

Attention: All Providers and Pharmacies Effective Date: June 12, 2020 Call to action: On June 5, 2020, the Texas Medical Board's (TMB) Executive Committee, with advice and direction from the Governor's Office, adopted rules on an emergency basis related to the issuance of certain prescriptions during the COVID-19 disaster. The emergency rule prohibits treatment of chronic pain with scheduled drugs through use of telemedicine medical services unless: i) a patient is an established chronic pain patient of the physician and is seeking telephone refill of an...

Provider Alert!

Provider Alert! Metformin ER drug recall due to NDMA impurity (Amneal Pharmaceuticals)

Attention: All Providers and Pharmacies Effective Date: June 4, 2020 Call to action: Amneal Pharmaceuticals LLC has issued a voluntary recall of several lots of Metformin Hydrochloride Extended Release Tablets USP 500mg, and 750mg. Amneal’s Metformin Hydrochloride Immediate Release Tablets are not affected by this recall. The recall is due to discovery of an impurity (N-nitrosodimethylamine [NDMA]) in the finished product. NDMA is classified as a probable human carcinogen that may be found in certain foods, drinking water, and industrial processes. Amneal has...

Provider Alert!

Provider Alert! Financial Management Services Agencies (FMSA)

Attention: Financial Management Services Agencies (FMSA) Subject: Cures Act EVV: The EVV Practice Period Begins July 1 Effective Date: 7/1/2020 Call to action: From July 1, 2020, through November 30, 2020, an Electronic Visit Verification (EVV) practice period will allow program providers and financial management services agencies (FMSAs) impacted by the 21st Century Cures Act to practice using the EVV system, EVV Portal, and EVV claims matching. Consumer directed services (CDS) employers can practice using the EVV system. EVV claims will not be denied...

Provider Alert!

Provider Alert! Prior authorizations for hospital beds reminder and new codes added

Attention: All Providers Effective date for new codes: August 26, 2020 Call to action: Texas Children’s Health Plan (TCHP) would like to remind you that the following hospital beds and accessories’ codes require prior authorization. This follows the guidance from the Texas Medicaid Provider Procedures Manual (TMPPM).   Code Description E 0184 Dry pressure mattress E0185 Gel or gel-like pressure pad for mattress, standard mattress length E0186 Air pressure mattress E0187 Water pressure mattress E0188 Synthetic sheepskin pad E0189 Lamb’s wool sheepskin pad, any size E0190 Positioning cushion/pillow/wedge, any shape or size E0193 Powered air flotation bed (low air loss therapy) E0194 Air...