News Blog

Provider Alert! COVID-19 Guidance for FMSAs and CDS Employers

Attention: All Providers Effective Date: March 20, 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.   STAR, STAR Kids, STAR Health, STAR+PLUS: COVID-19 Guidance for the Consumer Directed Services (CDS) Option   Background: In response to COVID-19, HHSC is providing guidance to MCOs and Financial Management Services Agencies (FMSAs) regarding requirements in the [...]

Provider Alert! CHIP co-pays waived for office visits in response to COVID-19

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.   To help families in accessing care during the COVID-19 response, TCHP supports the Health and Human Services’ decision to waive office visit co-payments for all CHIP members for services provided March 13, 2020, through April 30, 2020.Providers [...]

Provider Alert! Signature requirement waived on DME Forms due to COVID-19

Attention: DME Providers Effective Date: March 25, 2020 TCHP network providers should monitor the 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. To help ensure continuity of care during the COVID-19 response, Texas Children’s Health Plan (TCHP) supports the Health and Human Services’ decision not to require Durable Medical Equipment (DME) providers to obtain the [...]

Provider Alert!

Provider Alert! Select an EVV Vendor System or EVV Proprietary System Update

Attention: Financial Management Services Agencies (FMSA) Effective Date: May 1, 2020 Due to impacts of coronavirus, HHSC is extending the deadline to May to select an EVV system and begin the onboarding process. The original deadline was April 1,2020. Therefore, Financial Management Services Agencies (FMSAs) must select an Electronic Visit Verification or EVV Vendor System or EVV Proprietary System by May 1, 2020. How this impacts providers: All FMSAs currently contracted with MCOs or the Texas Health and Human Services Commission (HHSC).   Next steps [...]

Provider Alert!

Provider Alert! Reminder of mailing address and procedure for overpayments

Attention: All Providers Effective Date: March 20, 2020 Should a provider receive an overpayment from Texas Children’s Health Plan they should immediately take the following action. A provider has an obligation to notify Texas Children’s Health Plan in writing upon identification of an overpayment, no more than thirty (30) days from the date of discovery. The overpayment can be remediated through refund to Texas Children’s Health Plan, or a provider may request a recoupment from future claim payments.   For refunds: If a provider [...]

Provider Alert!

Provider Alert! New “Black Box” warning for Singulair (montelukast) and generic formulations

Attention: PCPs, Pulmonologists, and Pharmacists Effective Date: March 20, 2020 After careful analysis of the benefits and risks, the Food and Drug Administration (FDA) has strengthened the existing warnings on potential side effects on all Singulair and generic montelukast formulations. A “Black Box” warning has been included to stress the potential for serious side effects, including but not limited to serious behavior and mood-related changes. The FDA has also advised restricting the use for allergic rhinitis (hay fever) to those not [...]

Provider Alert! Anywhere Care (Telemedicine): How to become a participating provider

Attention: All Providers Effective Date: March 20, 2020 In order to reduce exposure to the Coronavirus Disease (COVID-19) and slow the spread of the illness, Texas Children’s Health Plan is promoting the use of Telemedicine, a covered benefit. We hope you are able to adapt your practice to delivering care via telemedicine. An increased use of telemedicine services will result in three immediate benefits: Preventing emergency rooms from being overcrowded. Limiting exposure among health care workers to infected individuals. Lessening the use of masks, gowns [...]

Provider Alert! COVID-19 Disaster Declaration – Texas Children’s Health Plan Operational Adjustments

Attention: All Providers Effective Date: March 13, 2020 TCHP affiliated providers should monitor the 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.   Reporting adjustments to normal provider business operations Texas Children’s Health Plan has developed a provider notification survey which is posted on the Provider portal www.texaschildrenshealthplan.org/for-providers and the website. This survey allows providers to self-report [...]

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

Attention: All Providers Effective Date: March 18, 2020 TCHP affiliated providers should monitor the 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.   As a result of the COVID-19 Disaster Declaration, TCHP has instituted the following:   In order to increase access to primary care services, TCHP is now waiving prior authorization requirements for out-of-network primary care visits [...]