Provider Alert

Articles with information about Provider Alerts.

Provider Alert!
26Apr

Provider Alert! EVV Alternative Device Phase-Out Schedule for Public Comment – Due by May 15

Date: April 26, 2024 Attention: STAR Kids Providers/Consumer Directed Services employers, and FMSA Providers Effective Date: May 15, 2024 Call to action: Texas Children’s Health Plan would like to inform program providers, financial management services agencies (FMSAs), and Consumer Direct Services (CDS) employers the Texas Health and Human Services Commission (HHSC) will be phasing out the use of alternative devices as an approved method to clock in and clock out of the Electronic Visit Verification (EVV) system to improve the accuracy of EVV. The...

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Provider Alert!
26Apr

Provider Alert! Change in Preferred Drug List Status for Antihyperuricemics Drug Class

Date: April 25, 2024 Attention: All Providers Effective date: April 22, 2024 Call to action: Effective April 22, 2024, the Texas Health and Human Services (HHS) removed non-preferred status from brand name Mitigare products. This is in response to the discontinuation of the brand products Colcrys by the manufacturer. The preferred status of the brand name Colcrys will not change to allow any remaining stock to be used. How this impacts providers: The change will allow providers to prescribe the generic without requiring PDL prior...

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Provider Alert!
24Apr

Provider Alert! Empowering Practices: A Hands-On Workshop on LARC Care and Client-Centered Contraceptive Counseling

Date: April 24, 2024 Attention: Obstetric Care Providers Workshop date: Thursday, May 2, 2024 Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers of an upcoming in-person long-acting reversible contraception (LARC) training opportunity for Houston-area obstetric care providers.  This event is sponsored by ASTHO’s Contraception Access Learning Community, in collaboration with Healthy Futures of Texas, Every Body Texas, University of Missouri-Kansas City School of Nursing and Health Studies, and the Texas Women’s Healthcare Coalition, is excited to invite you to...

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Provider Alert!
18Apr

Provider Alert! Clinical Criteria Implementation for Enzyme Replacement Hormonal Therapy Agents effective May 1, 2024

Date: April 18, 2024 Attention: All Providers Effective Date: May 1, 2024 Call to action: Texas Children’s Health Plan (TCHP) would like to let providers know that effective May 1, 2024, the Texas Health and Human Services (HHSC) will implement clinical prior authorizations to Adzynma (procedure code C9167) and Pombiliti (procedure code J1203) to the Enzyme Replacement Therapy (ERT) policy. Prior Authorization Requirements  Apadamtase alfa (Adzynma), procedure code C9167 is indicated to treat the following:  Pediatric and adult clients for prophylactic or on-demand ERT for congenital...

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Provider Alert!
18Apr

Provider Alert! Early Childhood Intervention (ECI) and Telehealth Services are not required to Use EVV

Date: April 17, 2024 Attention: Early Childhood Intervention and Telehealth Service Providers Effective date: January 1, 2024 Call to action: The purpose of this communication is to inform applicable service providers that Early Childhood Intervention (ECI) and home health services delivered via Telehealth are not required to use EVV for dates of service on or after January 1, 2024. Background: The Cures Act required states to implement Electronic Visit Verification (EVV) for Medicaid home health care services (HHCS) by Jan. 1, 2023. However, in...

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Provider Alert!
15Apr

Provider Alert! EVV Program Providers and FMSAs: Register for HHAeXchange Town Hall Webinars April 25 and May 30

Date: April 12, 2024 Attention: STAR Kids Providers/Consumer Directed Services employers, and FMSA Providers Call to action: Texas Children’s Health Plan (TCHP) would like to let program providers and financial management services agencies (FMSAs) know about the upcoming Electronic Visit Verification (EVV) Town Hall Webinar on Thursday, April 25, and Tuesday, May 30 from 1–3 p.m. (Central time). Agenda Overview of the EVV Transition EVV System Enhancements Addressing Key Concerns and Frequently Asked Questions Support Resources Q&A Session Click here to register. Next step for Providers: Providers are encouraged to share this communication...

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Provider Alert!
12Apr

Provider Alert! EVV Home Health Care Services (HHCS) Service Bill Codes Table Update Version 2.1

Date: April 12, 2024 Attention: STAR Kids Providers/Consumer Directed Services employers, and FMSA Providers Call to action: Texas Children’s Health Plan (TCHP) would like to inform applicable providers that a new version of the electronic visit verification (EVV) Health and Human Services (HHCS) Bill Codes Table has posted. The table is on the EVV 21st Century Cures Act webpage in Excel and PDF formats. Background:Effective January 1, 2024, Electronic Visit Verification (EVV) is required for Medicaid home health care services (HHCS). Program providers and financial management services agencies (FMSAs)...

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Provider Alert!
04Apr

Provider Alert! New Prior Authorization Resource to Determine Dates of Service

Date: April 3, 2024 Attention: All Providers Call to action: The purpose of this communication is to inform providers of a new resource available from Texas Medicaid and Healthcare Partnership (TMHP) available at https://www.tmhp.com/topics/prior-authorization/pa-calculator.  It is included on the TMHP prior authorization webpage. Providers are encouraged to utilize this calculator to calculate the dates of service that must be applied to the prior authorization form/prior authorization request.  By accessing TMHP’s tool, providers will save time and avoid having to resubmit or correct authorizations...

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Provider Alert!
02Apr

Provider Alert! TCHP Member Transportation Vendor Update

Date: April 2, 2024 Attention: All Providers Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that our former Member medical transportation provider, Veyo has transitioned to Medical Transportation Management (MTM). MTM operates both Non-Emergent Medical Transportation (NEMT) and Value Added Services (VAS) rides for Members. Members or your staff will still call the same number to schedule rides, 1-888-401-0170. Best of all, the transportation benefits will remain the same. As a reminder, the process for members to schedule...

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Provider Alert!
29Mar

Provider Alert! EVV Policy Updates Now Available for the Mobile Method Geo-Perimeter Expansion

Date: March 29, 2024 Attention: STAR Kids Providers/Consumer Directed Services employers and FMSA Providers Effective Date: April 1, 2024 Call to action: Texas Children’s Health Plan (TCHP) would like to let providers know Texas Health and Human Services Commission (HHSC) has posted the new and revised policies for mobile method effective April 1, 2024, that will be added to the Electronic Visit Verification (EVV) Policy Handbook in an upcoming handbook revision. These new and revised policies are outlined in the Increase in Geo-Perimeter...

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