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Provider Alert!
01Nov

Provider Alert! Abecma available on Medicaid formulary with prior authorization requirements

Date: October 26, 2021 Attention: Oncologists Effective Date: October 1, 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: Prescribers should be aware that Abecma (procedure code C9081) will be available to members through Texas Medicaid pharmacy benefit effective October 1, 2021. Access will require meeting...

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Provider Alert!
01Nov

Provider Alert! Breyanzi available on Medicaid formulary with prior authorization requirements

Date: October 26, 2021 Attention: Oncologists Effective Date: October 1, 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: Prescribers should be aware that Breyanzi (procedure code Q2054) will be available to members through Texas Medicaid pharmacy benefit effective October 1, 2021. Access will require meeting...

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Provider Alert!
01Nov

Provider Alert! Financial Management Services Agency Rate Methodology Evaluation Webinar Scheduled for November 5

Date: October 29, 2021 Attention: Financial Management Services Agency (FMSA) Webinar date: November 5, 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: Health and Human Services Commission (HHSC) Provider Finance Department contracted with a third-party vendor, Deloitte Consulting, to develop recommendations for a new rate...

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01Nov

Provider Alert! CME event is coming up. Register Today!

CME: Identifying and Responding to Human Trafficking Recognize the scope and impact of human trafficking and what physicians and other care professionals can do to help victims and support resources available. Wednesday, November 17, 2021 - 5:30 p.m. – 7:30 p.m. – Live stream via WebEx CME Objectives: Discuss the scope, diversity, and types of human trafficking in the United States Recognize vulnerability factors and identification of human trafficking victims to improve health outcomes Apply trauma informed techniques to enhance interactions with potential victims of human...

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20Oct

Provider Alert! COVID-19 Vaccine Administration Code 0004A Now a Medicaid Benefit

Date: October 18, 2021 Attention: Primary Care Providers Effective Date: Dates of service on or after September 22, 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: Effective for dates of service on or after September 22, 2021, in accordance with the U.S. Food and Drug...

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Provider Alert!
20Oct

Provider Alert! Health and Human Services Commission (HHSC) Release of Autism Services Benefits

Date: October 20, 2021 Attention: Primary Care Providers and Neurologists Effective Date: February 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: Effective for dates of service on or after February 1, 2022, Autism Services, to include Applied Behavior Analysis (ABA) evaluation and treatment, will...

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Provider Alert!
18Oct

Provider Alert! Alinia (Nitazoxanide) Formulary Change

Date: October 18, 2021 Attention: All Providers Effective date: November 23, 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: The Texas Vendor Drug Program (VDP) will be removing Alinia Suspension and tablet from the list of covered products effective November 23rd 2021. Nitazoxanide tablets will...

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Provider Alert!
11Oct

Provider Alert! Fetal Magnetic Resonance Imaging (MRI) Requires Prior Authorization

Date: October 11, 2021 Attention: All Providers Effective Dates: June 1, 2021 for code 74712 and April 1, 2021 for code 74713 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: Network providers submitting a prior authorization for fetal Magnetic Resonance Imaging (MRI) should include a current...

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Provider Alert!
01Oct

Provider Alert! 90-Day Notice of EVV Compliance for Cures Act Personal Care Services Providers

Date: October 1, 2021 Attention: Financial Management Services Agencies and Consumer Directed Services employers Effective Date: January 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: Effective January 1, 2022, the payers, Health and Human Servcies commission (HHSC) and TCHP, will begin Electronic Visit Verification...

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Provider Alert!
01Oct

Provider Alert! Misuse of EVV Reason Codes Requirements Removed

Date: October 1, 2021 Attention: Financial Management Services Agencies and Consumer Directed Services employers Effective Date: September 1, 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: The Health and Human Services Commission (HHSC) removed the Misuse of EVV Reason Codes Requirements from the EVV Reason...

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