News Blog

Provider Alert!
11Jan

Provider Alert! Providers are encouraged to register to Administer COVID-19 Vaccine

Attention: Primary Care Providers 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) aligns with the Texas Department of State Health Services (DSHS) with urging physicians and medical facilities to enroll in the DSHS Immunization Program in order to receive doses of and administer the COVID-19...

By Primary Care Providers, Provider Alert, 0 CommentsRead more...
08Jan

Provider Alert! COVID-19 Disaster Declaration – COVID-19 Testing expanded to include Out-of- Network (OON) Laboratories

Date: January 7, 2021 Attention: All Provider Notice Effective Date: NEW update for dates of service on or after October 6, 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. The content in this message will remain in effect throughout the COVID-19 Disaster Declaration period as announced by the...

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

Provider Alert! Prior Authorization Re-certification Requests Submission for Texas Medicaid

Date: January 7, 2021 Attention: Therapy Providers Effective Date: October 1, 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: Texas Children’s Health Plan (TCHP) aligns with the guidance on prior authorization (PA) recertification requests. In compliance with House Bill 3041 of the 86th Texas Legislature,...

By Provider Alert, Specialists, , , 0 CommentsRead more...
Provider Alert!
07Jan

Provider Alert! New prior authorization requirements for Mepolizumab (Nucala)

Date: December 21, 2020 Attention: Allergists & Immunologists, Pulmonologists Effective Date:  February 1, 2021 Call to action: Texas Children’s Health Plan (TCHP) is aligning prior authorization criteria for mepolizumab (Nucala), J2182, with the Texas Medicaid Provider Procedures Manual (TMPPM). Mepolizumab (Nucala) is a clinician administered drug indicated for members with severe asthma with an eospinophilic phenotype.   Mepolizumab (Nucala) is also indicated as a steroid sparing agent for certain types of hypereosinophilic syndrome (HES) and eosinophilic granulomatosis with polyangiitis (EGPA). Below are the new prior...

By Provider Alert, Specialists, , , 0 CommentsRead more...
06Jan

Provider Alert! COVID-19 Procedure Codes for the Introduction of Infusion of Therapeutics

Date: January 6, 2021 Attention: All Providers Effective Date: For dates of service on or after August 1, 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: Texas Children’s Health Plan (TCHP) aligns with the Centers for Medicare & Medicaid Services (CMS) in response to the...

By Facilities, OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , , 0 CommentsRead more...
Provider Alert!
30Dec

Provider Alert! Addition of Bamlanivimab and Casirivimab/Imdevimab as a Texas Medicaid Benefit and for FDA Emergency Use Authorization

Attention: All Providers       Effective Date: December 15, 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: Texas Children’s Health Plan would like to inform network providers that Texas Medicaid has added two medications, bamlanivimab and casirivimab/imdevimab, as outpatient benefits in response to the COVID-19 Emergency Use...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists0 CommentsRead more...
Provider Alert!
30Dec

Provider Alert! Healthy Texas Women Program Launches Enhanced Postpartum Care Services

Attention: Chemical dependency treatment facilities, opioid treatment programs, licensed professional counselors, licensed clinical social workers, psychologists and psychology groups, psychiatrists, and cardiologists Effective Date: December 29, 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: Texas Children’s Health Plan (TCHP) would like to ensure network...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists0 CommentsRead more...
Provider Alert!
28Dec

Provider Alert! Update to Kalydeco Clinical Prior Authorization Guidelines

Attention: Pulmonologists Effective Date: December 28, 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: Texas Children’s Health plan would like to inform network providers that effective December 28, 2020 Texas Medicaid will update the Kalydeco (ivacaftor) clinical prior authorization criteria. The changes reflect the...

By Office Managers, Primary Care Providers, Provider Alert, Specialists0 CommentsRead more...
Provider Alert!
22Dec

Provider Alert! Prior Authorization Requirements Guide

Attention: All Providers Effective Date: March 8, 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: Texas Children’s Health Plan (TCHP) would like to inform network providers of services that require a prior authorization effective March 8, 2021.Below are the services by category to...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists0 CommentsRead more...
Provider Alert!
16Dec

Provider Alert! Electronic Visit Verification (EVV) Cures Act Implementation January 1st 2021

Attention: Financial Management Services Agencies (FMSAs) Effective Date: 1/1/2021 Call to action: This serves as a final reminder that beginning January 1, 2021 all service visits for an EVV-required service must be captured in the EVV system. Federal law does not allow any further delays to implement the Cures Act EVV requirement for Medicaid personal care services. How this impacts providers: By Dec. 31, 2020: Complete Required Training Program providers, FMSAs, and CDS employers must complete the following EVV training requirements: EVV System Training before using the...

By Provider Alert, 0 CommentsRead more...