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Provider Alert! Collaborative Care Model (CoCM) Attestation Process to Update August 1, 2024
Date: July 26, 2024 Attention: All Providers Effective Date: August 1, 2024 Call to action: Texas Children’s Health Plan (TCHP) would like to... read more
Provider Alert! Updated Prior Authorization Criteria for Therapy with Burosumab-Twza (Crysvita)
Date: July 25, 2024 Attention: All Providers Effective date: July 1, 2024 Call to action: Texas Children’s Health Plan’s prior authorization (PA) criteria... read more
Provider Alert! Updated Prior Authorization Criteria for Elevidys
Date: July 24, 2024 Attention: All Providers Effective Date: September 1, 2024 Call to action: Texas Children’s Health Plan (TCHP) would like to... read more
Provider Alert! Update to Recertification or Extension Prior Authorization Requests for Nusinersen (Spinraza)
Date: July 23, 2024 Attention: All Providers Effective date: July 1, 2024 Call to action: The purpose of this communication is to inform... read more
Provider Alert! EVV Policy Reminder for Severe Weather
Date: July 19, 2024 Attention: STAR Kids Providers/Consumer Directed Services employers, and FMSA Providers Call to action: Texas Children’s Health Plan (TCHP)... read more
Provider Alert! Durable Medical Equipment Requests Exceeding Benefit Limitations
Date: July 23, 2024 Attention: All Providers Effective date: September 23, 2024 Call to action: Beginning September 23, 2024, Texas Children’s Health Plan... read more
Provider Alert! Update to Smallpox and Mpox Vaccine Reimbursement for Texas Medicaid
Date: July 12, 2024 Attention: All Providers Effective Date: August 1, 2024 Call to action: Texas Children’s Health Plan (TCHP) would like to... read more
Provider Alert! Important Information on Checks Sent by Change Healthcare
Date: July 12, 2024 Attention: All Providers Texas Children’s Health Plan (TCHP) has just been notified that due to a process failure... read more
Timeline
July 2024
Provider Alert! Collaborative Care Model (CoCM) Attestation Process to Update August 1, 2024
Date: July 26, 2024 Attention: All Providers Effective Date: August 1, 2024 Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that effective August 1, 2024, the Attestation Form for the Collaborative Care Model (CoCM) in Texas Medicaid will be removed from the Texas Medicaid & Healthcare Partnership (TMHP) website and made available in the Provider Enrollment and Management System (PEMS). Prior to delivering CoCM services, applicable providers will be required to complete the CoCM attestation form in PEMS to...
Provider Alert! Updated Prior Authorization Criteria for Therapy with Burosumab-Twza (Crysvita)
Date: July 25, 2024 Attention: All Providers Effective date: July 1, 2024 Call to action: Texas Children’s Health Plan’s prior authorization (PA) criteria for renewal or continuation therapy with burosumab-twza (Crysvita) has changed, effective for dates of service on or after July 1, 2024. TCHP’s criteria for determining medical necessity for renewal or continuation therapy with burosumab-twza (Crysvita) is aligned with Texas Medicaid policy, as outlined in Texas Medicaid Provider Procedures Manual including the following update: Clinical documentation from the physician must confirm that the...
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Provider Alert! Collaborative Care Model (CoCM) Attestation Process to Update August 1, 2024
Date: July 26, 2024 Attention: All Providers Effective Date: August 1, 2024 Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that effective August 1, 2024, the Attestation Form for the Collaborative Care Model (CoCM) in Texas Medicaid will be removed from the Texas Medicaid & Healthcare Partnership (TMHP) website and made available in the Provider Enrollment and Management System (PEMS). Prior to delivering CoCM services, applicable providers will be required to complete the CoCM attestation form in PEMS to...
Provider Alert! Updated Prior Authorization Criteria for Therapy with Burosumab-Twza (Crysvita)
Date: July 25, 2024 Attention: All Providers Effective date: July 1, 2024 Call to action: Texas Children’s Health Plan’s prior authorization (PA) criteria for renewal or continuation therapy with burosumab-twza (Crysvita) has changed, effective for dates of service on or after July 1, 2024. TCHP’s criteria for determining medical necessity for renewal or continuation therapy with burosumab-twza (Crysvita) is aligned with Texas Medicaid policy, as outlined in Texas Medicaid Provider Procedures Manual including the following update: Clinical documentation from the physician must confirm that the...
Provider Alert! Updated Prior Authorization Criteria for Elevidys
Date: July 24, 2024 Attention: All Providers Effective Date: September 1, 2024 Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that Texas Health and Human Services Commission (HHSC) updated the prior authorization criteria for Elevidys (procedure code J1413), a benefit of Medicaid and CHIP, as the result of a recent review by the FDA. The update is effective September 1, 2024, for fee-for-service Medicaid clients. Elevidys (delandistrogene moxeparvovec-rokl) is an adeno-associated virus vector-based gene therapy indicated for the treatment of...
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Provider Alert! Collaborative Care Model (CoCM) Attestation Process to Update August 1, 2024
Date: July 26, 2024 Attention: All Providers Effective Date: August 1, 2024 Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that effective August 1, 2024, the Attestation Form for the Collaborative Care Model (CoCM) in Texas Medicaid will be removed from the Texas Medicaid & Healthcare Partnership (TMHP) website and made available in the Provider Enrollment and Management System (PEMS). Prior to delivering CoCM services, applicable providers will be required to complete the CoCM attestation form in PEMS to...
Provider Alert! Updated Prior Authorization Criteria for Therapy with Burosumab-Twza (Crysvita)
Date: July 25, 2024 Attention: All Providers Effective date: July 1, 2024 Call to action: Texas Children’s Health Plan’s prior authorization (PA) criteria for renewal or continuation therapy with burosumab-twza (Crysvita) has changed, effective for dates of service on or after July 1, 2024. TCHP’s criteria for determining medical necessity for renewal or continuation therapy with burosumab-twza (Crysvita) is aligned with Texas Medicaid policy, as outlined in Texas Medicaid Provider Procedures Manual including the following update: Clinical documentation from the physician must confirm that the...
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Provider Alert! Collaborative Care Model (CoCM) Attestation Process to Update August 1, 2024
Date: July 26, 2024 Attention: All Providers Effective Date: August 1, 2024 Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that effective August 1, 2024, the Attestation Form for the Collaborative Care Model (CoCM) in Texas Medicaid will be removed from the Texas Medicaid & Healthcare Partnership (TMHP) website and made available in the Provider Enrollment and Management System (PEMS). Prior to delivering CoCM services, applicable providers will be required to complete the CoCM attestation form in PEMS to...
Provider Alert! Updated Prior Authorization Criteria for Therapy with Burosumab-Twza (Crysvita)
Date: July 25, 2024 Attention: All Providers Effective date: July 1, 2024 Call to action: Texas Children’s Health Plan’s prior authorization (PA) criteria for renewal or continuation therapy with burosumab-twza (Crysvita) has changed, effective for dates of service on or after July 1, 2024. TCHP’s criteria for determining medical necessity for renewal or continuation therapy with burosumab-twza (Crysvita) is aligned with Texas Medicaid policy, as outlined in Texas Medicaid Provider Procedures Manual including the following update: Clinical documentation from the physician must confirm that the...
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Provider Alert! Collaborative Care Model (CoCM) Attestation Process to Update August 1, 2024
Date: July 26, 2024 Attention: All Providers Effective Date: August 1, 2024 Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that effective August 1, 2024, the Attestation Form for the Collaborative Care Model (CoCM) in Texas Medicaid will be removed from the Texas Medicaid & Healthcare Partnership (TMHP) website and made available in the Provider Enrollment and Management System (PEMS). Prior to delivering CoCM services, applicable providers will be required to complete the CoCM attestation form in PEMS to...
Provider Alert! Updated Prior Authorization Criteria for Therapy with Burosumab-Twza (Crysvita)
Date: July 25, 2024 Attention: All Providers Effective date: July 1, 2024 Call to action: Texas Children’s Health Plan’s prior authorization (PA) criteria for renewal or continuation therapy with burosumab-twza (Crysvita) has changed, effective for dates of service on or after July 1, 2024. TCHP’s criteria for determining medical necessity for renewal or continuation therapy with burosumab-twza (Crysvita) is aligned with Texas Medicaid policy, as outlined in Texas Medicaid Provider Procedures Manual including the following update: Clinical documentation from the physician must confirm that the...
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Provider Alert! Collaborative Care Model (CoCM) Attestation Process to Update August 1, 2024
Date: July 26, 2024 Attention: All Providers Effective Date: August 1, 2024 Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that effective August 1, 2024, the Attestation Form for the Collaborative Care Model (CoCM) in Texas Medicaid will be removed from the Texas Medicaid & Healthcare Partnership (TMHP) website and made available in the Provider Enrollment and Management System (PEMS). Prior to delivering CoCM services, applicable providers will be required to complete the CoCM attestation form in PEMS to...
Provider Alert! Updated Prior Authorization Criteria for Therapy with Burosumab-Twza (Crysvita)
Date: July 25, 2024 Attention: All Providers Effective date: July 1, 2024 Call to action: Texas Children’s Health Plan’s prior authorization (PA) criteria for renewal or continuation therapy with burosumab-twza (Crysvita) has changed, effective for dates of service on or after July 1, 2024. TCHP’s criteria for determining medical necessity for renewal or continuation therapy with burosumab-twza (Crysvita) is aligned with Texas Medicaid policy, as outlined in Texas Medicaid Provider Procedures Manual including the following update: Clinical documentation from the physician must confirm that the...
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