Tag - cystic fibrosis

Provider Alert!

Provider Alert! Clinical Criteria Update for Orkambi Effective November 9

Date: October 25, 2022 Attention: Providers Effective Date: October 1, 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: Texas Children Health Plan (TCHP) will revise clinical prior authorization criteria for Orkambi (lumacaftor/ivacaftor) to comply with the recent Food and Drug Administration-approved age indications. How this impacts...

Provider Alert!

Provider Alert! Cystic Fibrosis and Spinal Muscular Atrophy Screening Authorization No Longer Required

Date: May 27, 2021 Attention: Obstetric Care Providers Effective Date: June 1, 2021 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 network providers that beginning June 1, 2021; a prior authorization is no longer required for the...

Provider Alert!

Provider Alert! Clinical Prior Authorization Updates for Cystic Fibrosis Agents

Date: February 25, 2021 Attention: Pulmonologists Effective Date: April 6, 2021 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 April 6, 2021, the Texas Health and Human Services Commission (HHSC) will update the cystic fibrosis (CF) agents prior authorization criteria to reflect recent FDA-approved indication...