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Provider Alert!
13Jul

Provider Alert! All MCOs: Dupixent, Evrysdi, and Qelbree Clinical Prior Authorization Criteria Updates

Date: July 13, 2022 Attention: Providers Effective Date: August 2, 2022 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: HHSC is revising the prior authorization (PA) criteria for the following drugs: Dupixent, Evrysdi and Qelbree. How this impacts providers: HHSC made the following revisions: Dupixent clinical PA criteria: Added...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , , 0 CommentsRead more...
Provider Alert!
13Jul

Provider Alert! Removal of Specialist Requirements from CAD Clinical Policies and Prior Authorization Criteria

Date: July 13, 2022 Attention: Providers Effective Date: August 1, 2022 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: HHSC is updating the prior authorization criteria for some clinician administered drugs. How this impacts providers: HHSC will no longer require the prescription include consultation with or be...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, 0 CommentsRead more...
12Jul

Provider Alert! Pediatric Updates for Moderna & Pfizer-BioNTech COVID-19 Vaccines

Date: July 12, 2022 Attention: All Providers Effective Date: June 17, 2022 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with 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) would like to inform providers that on June 17, 2022, the U.S. Food and Drug Administration (FDA) authorized emergency use of...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, Uncategorized, , 0 CommentsRead more...
Provider Alert!
08Jul

Provider Alert! Medicaid Preferred Drug List and Formulary Changes

Date: July 6, 2022 Attention: All Providers Effective Date: July 28, 2022 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with 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) would like to inform providers that the Texas Vendor Drug Program (VDP) implemented changes to the state Medicaid drug formulary, effective...

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

Provider Alert! First Quarter 2022 HCPCS Updates for Texas Medicaid 

Date: July 5, 2022 Attention: Providers Effective Date: April 1, 2022 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with 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: On March 24, 2022, Texas Medicaid and Healthcare Partnership (TMHP) implemented the first quarter 2022 Healthcare Common Procedure Coding System (HCPCS) additions, revisions, and discontinuations, which will be effective...

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06Jul

Provider Alert! : COVID-19 Drug Veklury (Remdesivir) Update

Date: July 5, 2022 Attention: All Providers Effective Date: April 25, 2022 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with 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) would like to inform providers that effective April 25, 2022, Veklury (J0248) is a covered benefit for Medicaid and CHIP clients...

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Provider Alert!
06Jul

Provider Alert! Antivenin Procedure Code J0841 (ANAVIP®) to Become a Medicaid Benefit

Date: July 5, 2022 Attention: All Providers Effective Date: June 1, 2022 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) would like to inform providers that Health and Human Services Commission (HHSC) has identified an alternative antivenom, Antivenin (ANAVIP) that is...

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06Jul

Provider Alert! Monoclonal Antibody Procedure Code Q0221 for Treatment of COVID-19 Added to Texas Medicaid Benefits

Date: July 5, 2022 Attention: All Providers   Effective Date: February 24, 2022 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with 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: On February 24, 2022, the Centers for Medicare and Medicaid Services (CMS) created a new procedure code, Q0221, reflecting a revised U.S. Food and Drug...

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06Jul

Provider Alert! Procedure Codes M0222, M0223 & Q0222 for COVID-19 Treatments Added as Texas Medicaid & CHIP Benefits

Date: July 5, 2022 Attention: All Providers Effective Date: February 11, 2022 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: On February 11, 2022, the U.S. Food and Drug Administration (FDA) issued an Emergency Use Authorization (EUA) for the emergency use of bebtelovimab for the treatment...

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

Provider Alert! COVID-19 Convalescent Plasma Benefit Modified

Date: July 5, 2022 Attention: All Providers Effective Date: December 28, 2021 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: On February 10, 2022, the U.S. Food and Drug Administration (FDA) issued an Emergency Use Authorization (EUA) for the emergency use of COVID-19 convalescent plasma with...

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