OB/GYNs

Articles with relevant information for OB/GYNs

Provider Alert!
03Jun

Provider Alert! Financial Management Services Agencies (FMSA)

Attention: Financial Management Services Agencies (FMSA) Subject: Cures Act EVV: The EVV Practice Period Begins July 1 Effective Date: 7/1/2020 Call to action: From July 1, 2020, through November 30, 2020, an Electronic Visit Verification (EVV) practice period will allow program providers and financial management services agencies (FMSAs) impacted by the 21st Century Cures Act to practice using the EVV system, EVV Portal, and EVV claims matching. Consumer directed services (CDS) employers can practice using the EVV system. EVV claims will not be denied...

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Provider Alert!
01Jun

Provider Alert! Prior authorizations for hospital beds reminder and new codes added

Attention: All Providers Effective date for new codes: August 26, 2020 Call to action: Texas Children’s Health Plan (TCHP) would like to remind you that the following hospital beds and accessories’ codes require prior authorization. This follows the guidance from the Texas Medicaid Provider Procedures Manual (TMPPM).   Code Description E 0184 Dry pressure mattress E0185 Gel or gel-like pressure pad for mattress, standard mattress length E0186 Air pressure mattress E0187 Water pressure mattress E0188 Synthetic sheepskin pad E0189 Lamb’s wool sheepskin pad, any size E0190 Positioning cushion/pillow/wedge, any shape or size E0193 Powered air flotation bed (low air loss therapy) E0194 Air...

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Provider Alert!
28May

Provider Alert! Housing Choice Plan Survey

Attention: All Providers Effective Date: Survey open May 15, 2020 until June 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: The Health and Human Services Commission’s (HHSC) Behavioral Health Advisory Committee has approved the development of a Housing Choice Plan for individuals with...

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21May

Register for the June CME: COVID-19 Looking to the Future

COVID-19 – Looking to the Future: Where are we now and where do we go from here? Presented by Texas Children’s Health Plan Wednesday, June 17, 2020 – 5:30-7:30 p.m. – Live stream via WebEx Topics covered will include: Progress toward a COVID-19 Vaccine Fall 2020: Managing COVID-19 and the Flu in a Pediatrics Practice Telemedicine: How to Keep the Momentum Going Q&A with Dr. Lisa Hollier The CME will be presented by: Dr. Mark Ward Director, Pediatric Residency Program Baylor College of Medicine/Texas Children’s Hospital Dr. Robert Ball Medical Director, eHealth Texas Children’s...

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Provider Alert!
20May

Provider Alert! Reminder: Authorization Guidelines for a hospitalized member – post discharge services and supplies

Attention: All Providers Effective Date: May 20, 2020 Call to action: Texas Children’s Health Plan (TCHP) is aligned with the Uniform Managed Care Contract (UMCC) Guideline for members with an authorization request during hospitalization (reference: 8.1.8 Utilization Management). The guideline states that TCHP must issue coverage determinations for a member who is hospitalized at the time of the request, within one Business Day of receiving the request for services or equipment that will be necessary for the care of the Member immediately...

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11May

Provider Alert! Families First Coronavirus Response Act Information

Attention: Financial Management Services Agencies and Consumer Directed Services employers Effective Date: This rule is in effect April 2, 2020 to December 31, 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: The United States Department of Labor (DOL) issued a temporary rule implementing...

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Provider Alert!
11May

Provider Alert! Live EVV Training Webinars in June

Attention: Existing Electronic Visit Verification (EVV) Users Effective Date: June 16-June 17 Call to action: In June, the Health and Human Services Commission (HHSC) and Texas Medicaid & Healthcare Partnership (TMHP) will hold live Electronic Visit Verification (EVV) policy and EVV Portal training webinars for program providers currently required to use EVV. How this impacts providers: Program providers must complete EVV Portal training and EVV policy training annually. See the following link for more information: https://hhs.texas.gov/sites/default/files/documents/doing-business-with-hhs/providers/long-term-care/evv/evv-required-training-checklist.pdf Next steps for providers: To meet the annual training requirement,...

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Provider Alert!
11May

Provider Alert! Cures Act EVV: Required EVV Training Webinars in May and June

Attention: Financial Management Services Agencies (FMSA) Effective Date: 6/2/2020 – 6/3/2020 Call to action: In May and June, the Health and Human Services Commission (HHSC) and Texas Medicaid & Healthcare Partnership (TMHP) will hold live Electronic Visit Verification (EVV) policy and EVV Portal training webinars for program providers and financial management service agencies (FMSAs) required to use EVV by the Cures Act. How this impacts providers: Program providers and FMSAs affected by the Cures Act EVV expansion must complete EVV Portal training and EVV policy...

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07May

Provider Alert! COVID-19 Medicaid Pharmacy Benefit Updated May 4, 2020

Attention: All Providers and Pharmacies Effective Date: May 4, 2020 The Texas Vendor Drug Program (VDP) has implemented several changes in response to COVID-19. This notice contains the latest updates, as well as links to the previously implemented changes. No-auto prior authorization (NAP) designation temporarily lifted: Normally, medications listed as NAP on the drug formulary by VDP require a manual hard stop in the system. Providers must call/fax to complete a prior authorization (PA) rather than allowing automated authorizations by reviewing historical pharmacy...

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Provider Alert!
21Apr

Provider Alert! VDP Formulary Updates – Update 3

Attention: All Providers and Pharmacies Effective Date: April 21, 2020 Call to action: VDP temporarily revised the preferred drug list to address reported possible drug shortages. A new claims processing edit has also been added to prevent overutilization of antimalarial drugs. Expanded NDCs: The non-preferred status of certain generic formulation NDCs were temporarily removed. The change allows pharmacies to dispense these drugs without requiring a non-preferred prior authorization, and provide continued access to necessary medication. The full list of NDCs can be found...

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