Monthly Archives - October 2020

Provider Alert!

Provider Alert! New prior authorization requirements for Burosumab-Twza(Crysvita)

Attention: Nephrologists and Endocrinologists Effective Date: 1/6/2021 Call to action: Texas Children’s Health Plan (TCHP) is aligning prior authorization criteria for burosumab-twza (Crysvita), J0584, with the Texas Medicaid Provider Procedures Manual (TMPPM). Crysvita is a clinician administered drug indicated for members with X-linked hypophosphatemia (XLH) and Fibroblast Growth Factor 23 (FGF23)-related hypophosphatemia. Below are the new prior authorization criteria for TCHP members effective 01/06/2021. For initial therapy, the following criteria must be met: The client has a diagnosis of X-linked hypophosphatemia (XLH)...

Provider Alert!

Provider Alert! Concerta® to return to non-preferred status

Attention: All Providers Effective Date: October 16, 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: The Texas Vendor Drug Program (VDP) updated the Texas Medicaid formulary for STAR and STAR Kids members. The branded formulations of Concerta (methylphenidate ER) will be moved back to the non-preferred...