Specialists

Articles with relevant information for Specialists.

Provider Alert!
11Jan

Provider Alert! Collaborative Care Model (CoCM) in Texas Medicaid computer-based training

Date: January 11, 2023 Attention: All Providers Date training is available: January 4, 2023 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 make providers aware of a training opportunity. Texas Medicaid implemented a medical benefit for the CoCM on...

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Provider Alert!
05Jan

Provider Alert! Prior Authorization Criteria Update for Amvuttra

Date: December 29, 2022 Attention: All Providers Effective date: February 1, 2023 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, February 1,2023, the Texas Health and Human Services Commission (HHSC) will update the prior authorization criteria for Amvuttra (procedure code J0225). Amvuttra (vutrisiran) is a transthyretin-directed...

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Provider Alert!
05Jan

Provider Alert! Medicaid Preferred Drug List and Formulary Changes

Date: December 29, 2022 Attention: Providers Effective Date: January 26, 2023 Call to action: Effective January 26, 2023, select medication(s) moved from “preferred” to “non-preferred” status and vice-versa. Texas Children’s Health Plan wants to notify providers so that these changes do not impact the ability of your STAR and STAR Kids members to obtain their medications.  A summary of the changes is included below. Resource: https://www.txvendordrug.com/formulary/preferred-drugs Changes with biggest impact to Texas Children Health Plan members and providers: MedicationTypePreferred alternativesCiproflaxacin suspension [G]AntibioticCipro suspension [B]E.E.S. (erythromycin) granules...

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Provider Alert!
28Dec

Provider Alert! Synagis Prior Authorization Guidance – Reminder

Date: December 28, 2022 Attention: All 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: Beginning with the 2022-23 Human Respiratory Syncytial Virus (RSV) season, the Texas Health and Human Services Commission (HHSC) implemented simplified approval criteria for Synagis subsequent dosing (renewals). Pharmacies will no...

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Provider Alert!
22Dec

Provider Alert! Update: System Configuration Resolution Complete for MDCP Providers

Date: December 22, 2022 Attention: MDCP 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: The issue that we reported to providers last week regarding the new STAR Kids billing matrix effective December 1, 2022 has been corrected. Our system has been updated and we...

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21Dec

Provider Alert! Genabio COVID-19 At-Home Test Kit Added to Formulary

Date: December 21, 2022 Attention: All Providers Effective date: November 21, 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 November 21, 2022, the Health and Human Services Commission (HHSC) added two new COVID-19 test kits are available as a reimbursable pharmacy benefit. Genabio is now...

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Provider Alert!
21Dec

Provider Alert! Variable Schedules Available in EVV Vendor Systems

Date: December 20, 2022 Attention: STAR Kids Providers/Consumer Directed Services employers, and FMSA 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: Background information: S.B. No. 1648 requires HHSC to allow a health care provider to enter a variable schedule into the electronic visit verification system. HHSC...

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Provider Alert!
Provider Alert!
20Dec

Provider Alert! Hepatitis C Treatment Coverage and PDL Update Scheduled for January 1

Date: December 20, 2022 Attention: All Providers Effective date: January 1, 2023 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: On January 1, 2023, the Texas Health and Human Services Commission (HHSC) will designate one medication as the preferred direct-acting antiviral (DAA) drug option for treating...

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Provider Alert!
16Dec

Provider Alert! System Configuration Resolution in Progress for MDCP Providers

Date: December 16, 2022 Attention: MDCP 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) would like to notify providers of an internal system configuration issue that has been identified regarding the new STAR Kids billing matrix that went live...

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Provider Alert!
16Dec

Provider Alert! Correction to Rendering Provider Guidance Previously Provided

Date: December 16, 2022 Attention: All Providers   This communication is an update to the communication providedon November 23, 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: Please note this communication is a correction to the communication provided on November 23,2022. How this impacts providers: TCHP would...

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