Tag - Formulary

Provider Alert!

Provider Alert! Updated National Drug Codes Added to Medicaid, CHIP Formularies

Date: May 31, 2024 Attention: Providers Effective date: May 8 and May 10, and May 16, 2024 Call to action: Texas Children’s Health Plan would like to inform providers that the Vendor Drug Program added the new drugs to the table available below, effective May 8, 2024, May 10, and May 16, 2024. National Drug CodeDrug NameEffective Date00173090442NUCALA 40 MG/0.4 ML SYRINGE5/8/202415370030560POKONZA 10 MEQ PACKET5/8/202464406003002ZURZUVAE 25 MG CAPSULE5/10/202464406003101ZURZUVAE 30 MG CAPSULE5/10/202468682013350CLINDAMYC-BNZ PEROX 1.2-3.75/10/202472786010202OXBRYTA 300 MG TABLET5/10/202472786010203OXBRYTA 300 MG TABLET5/10/202472205018138PIRFENIDONE 267 MG TABLET5/10/202459651020623NITROFURANTOIN 25 MG/5...

Provider Alert!

Provider Alert! Updated: Medicaid Preferred Drug List and Formulary Changes

Date: January 18, 2024 Attention: All Providers Effective Date: January 26, 2024 This is an update for a communication that was previously posted on 12/18/2023. Call to action: Texas Children’s Health Plan (TCHP) would like to let providers know that effective January  26, 2024, select medication(s) moved from “preferred” or “non-reviewed” to “non-preferred” status. 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: The drugs listed below were either not previously reviewed (NR)...

Provider Alert! Addition of Paxlovid (Pfizer Oral Covid-19 Drug) to Formulary

Date: January 8, 2024 Attention: Providers Effective date: January 4, 2024 Call to action: Texas Children’s Health Plan (TCHP) would like to let providers know that effective January 4, 2024, the Texas Health and Human Services (HHS) added Paxlovid to the formulary. Paxlovid (nirmatrelvir co-packaged with ritonavir) is an oral antiviral tablet, is indicated for the treatment of mild-to-moderate COVID-19 in adults who are at high risk for progression to severe COVID-19, including hospitalization or death. How this impacts providers: Please see below for the list...

Provider Alert!

Provider Alert! Medicaid Preferred Drug List and Formulary Changes

Date: December 18, 2023 Attention: Providers Effective Date: January 25, 2024 Call to action: Texas Children’s Health Plan (TCHP) would like to notify providers that effective January 26, 2024, select medication(s) moved from “preferred” or “non-reviewed” to “non-preferred” status. 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: The drugs listed below were either not previously reviewed (NR) and became non-preferred (NPD) or previously considered a preferred agent (PDL) but now have...

Provider Alert! 2023 COVID-19 Vaccine Currently Not Covered on Texas Medicaid and CHIP Formulary

Date: November 3, 2023 Attention: All Providers Call to action:  As of November 1, 2023, COVID vaccines are currently unavailable on the Medicaid and CHIP Formulary at this time. Texas Health and Human Services Commission (HHSC) is working on ways to add the COVID-19 vaccines to the pharmacy benefit. Texas Children’s Health Plan (TCHP) will provide more information as it becomes available.  Next steps for providers:   In the meantime, should your patient inquire about the COVID-19 vaccine, please encourage your patients to receive their...

Provider Alert! Monovalent Moderna and Pfizer-BioNTech COVID-19 Vaccines Removed From Formulary on April 21, 2023

Date: May 8, 2023 Attention: All Providers Effective Date: April 21, 2023 Call to action: Texas Children Health Plan (TCHP) would like to inform providers that effective April 21, 2023, the U.S. Food and Drug Administration (FDA) amended the emergency use authorizations of the Moderna and Pfizer-BioNTech COVID-19 bivalent mRNA vaccines. This is to simplify the vaccination schedule for most individual vaccines, and monovalent are no longer authorized for use in the United States. This announcement includes authorizing the current bivalent vaccines (original and...

Provider Alert!

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...

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...

Provider Alert!
Provider Alert!

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...

Provider Alert!

Provider Alert! Medicaid Preferred Drug List and Formulary Changes

Date: July 6, 2022 Attention: All Providers Effective Date: July 28, 2022 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with 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 providers that the Texas Vendor Drug Program (VDP) implemented changes to the state Medicaid drug formulary, effective...