Provider Alert

Articles with information about Provider Alerts.

Provider Alert!
03Sep

Provider Alert! Inhaled Glucocorticoids and Insulin Products Return to Non-Preferred for Medicaid Members

Attention: All Providers Effective Date: September 18, 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: Beginning September 18, 2020 the Texas Vendor Drug Program (VDP) will restore non-preferred status to some of the inhaled glucocorticoids and insulin products. VDP temporarily removed non-preferred status from these...

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Provider Alert!
02Sep

Provider Alert! 2020-21 RSV Season and Synagis (palivizumab)

Attention: All Providers Effective Date: September 24, 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: Respiratory Syncytial Virus (RSV) season is here! The Texas RSV region schedule and map can be found on the Texas Health and Human Services (HHSC) Vendor Drug Program (VDP) website. ...

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Provider Alert!
02Sep

Provider Alert! CMS Approves Multiple Allowances to Support Providers with Improving Performances and Incentive Payments Alike due to COVID-19 Pandemic

Attention: All Providers Effective Date: August 27, 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 inform you of the following notice from Health and Human Services Commission (HHSC). The COVID-19 pandemic has resulted in significant changes in care...

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Provider Alert!
25Aug

Provider Alert! Outpatient Medical Drug Billing Requirements Reminder

Attention: All Providers Effective Date: September 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: Effective September 1, 2020, TCHP will reject outpatient medical drug claims for clinician administered drugs (CADs) without the proper national drug code (NDC), healthcare common procedure coding system (HCPCS), and billing unit combination. The...

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Provider Alert!
20Aug

Provider Alert! Prior Authorization Guideline updates for Private Duty Nursing (PDN) and therapy specialty services

Attention: All Providers Effective Date: July 18, 2020 for PDN and August 11, 2020 for therapy Services 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: TCHP would like to inform you of recent updates to the prior authorization requirements and the effective dates. Updates include...

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Provider Alert!
20Aug

Provider Alert! Uniform Opioid Policy Begins September 1

Attention: All Providers Effective Date: September 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: Effective September 1, 2020, the Vendor Drug Program (VDP) will implement a uniform opioid policy to encourage appropriate use and reduce opioid over-prescribing. The opioid policy does not apply to chronic pain, pain...

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Provider Alert!
19Aug

Reminder: Mandatory PMP verification to prescribe and dispense certain controlled substances

Attention: All Providers Effective Date: August 18, 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: This is a reminder that as of March 1, 2020, pharmacists and prescribers have been required to check the patient’s Prescription Monitoring Program (PMP) history before prescribing or dispensing...

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Provider Alert!
12Aug

Provider Alert! Generic Albuterol Products Return to Non-Preferred Status for Medicaid Members

Attention: All Providers Effective Date: August 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: Beginning August 28, 2020 the Texas Vendor Drug Program (VDP) will restore non-preferred status to a number of generic albuterol products. VDP temporarily removed nonpreferred status from these products...

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Provider Alert!
06Aug

Provider Alert! Providers who are leaving the TCHP Participating Provider Network

Attention: All Providers Effective Date: State Fiscal QTR 3 & 4 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 and its continued governmental Emergency Declaration. CHANGES TO THE TCHP PARTICIPATING PROVIDER NETWORK The following is a list of providers and practitioners that have left and/or will be leaving...

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Provider Alert!
05Aug

Provider Alert! Preferred Generic Stimulant Available on the TX Medicaid Formulary

Attention: All Providers Effective Date: July 30, 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: Effective Thursday, July 30, 2020, the Texas Vendor Drug Program (VDP) updated the Texas Medicaid formulary for STAR and STAR Kids members. The generic formulations of Adderall XR (amphetamine/dextroamphetamine ER) is...

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