Provider Alert! Coram Infusion Pharmacies: Eliminating Certain Services in Texas

Date: June 29, 2022

Attention: Primary Care Providers and Referring Providers

Effective Immediately

Call to action: Coram Infusion Pharmacies informed TCHP that it will no longer support certain post-acute infusion therapies such as TPN, antibiotics, inotropes, and hydration in Texas. However, Coram will continue to provide specialty pharmacy and enteral feedings.

How this impacts providers: TCHP will work with Coram Infusion Pharmacies to assist Members currently receiving eliminated services. To ensure there is no disruption in care, TCHP will coordinate transition of infusion services to alternative in-network home infusion providers with Members and Referring Providers no later than July 31, 2022.

Providers should be aware that new authorization requests may be needed for services that extend beyond July 31, 2022.

Next steps for providers:

Access to care and continuity of care is of utmost importance to our Members and participating Providers. To ensure that coordination of care and services for our members during this transition period is optimal, Providers should note the following guidance:

Refer to TCHP participating home infusion providers:

Providers are expected to use in-network providers for patient referrals.

The current listing of TCHP participating infusion providers can be found on the TCHP Online Directory:

• Link to https://www.texaschildrenshealthplan.org/doctor
• Search for “infusion services”

The list continues to be updated but some alternative providers currently include:

• Healthy Connections Homecare Services, Inc. dba Option Care Women’s Health
• Advanced Pediatric Care, Inc.
• Unicare Home Health Services of Tyler, Inc.
• Healthquest Infusion and Specialty
• Optum Infusion Services, via single case agreement
• Soleo, via single case agreement

If you need assistance at any time, please contact TCHP Member Services Department:

• STAR: 832-828-1001 or 1-866-959-2555
• CHIP: 832-828-1002 or 1-866-959-6555
• STAR Kids: contact the Member’s assigned Service Coordinator. If you need this information, please call 1-800-659-5764.

Additional resources:

• Utilization Management Guidelines
  • texaschildrenshealthplan.org/TCHP Utilization Management Guidelines

• In-network vs. out of network providers for patient referrals
  • In-network providers can be found at: https://www.texaschildrenshealthplan.org/doctor
  • There may be times when a Primary Care Provider (PCP) or specialty provider believes it is critical for a member to receive care from a provider outside of the TCHP network.
    • In these cases, the ordering Provider should initiate a written authorization in order for the visit to be covered.
    • Such requests are reviewed by the Medical Director for authorization of medically necessary services that are not available from any other TCHP network provider.

If you have any questions, please email Provider Network Management at: providerrelations@texaschildrens.org.

For access to all provider alerts, log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.