Tag - Formulary

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...

Provider Alert! Booster Dose Moderna COVID-19 Vaccine for Adults Added to the Formulary

Date: May 31, 2022 Attention: All Providers Effective Date: May 13, 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 U.S. Food and Drug Administration (FDA), under an emergency use authorization (EUA), authorized the...

Provider Alert!

Provider Alert! Medicaid Preferred Drug List and Formulary Changes

Date: January 25, 2022 Attention: All Providers Subject: Medicaid Preferred Drug List and Formulary Changes Effective Date: January 27, 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: The Texas Vendor Drug Program (VDP) implemented changes to the state Medicaid drug formulary, effective Thursday, January 27, 2022....

Provider Alert! Merck Oral COVID-19 drug, Molnupiravir, Added to Formulary

Date: January 24, 2022 Attention: Primary care providers Effective Date: January 3, 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: HHSC added Molnupiravir to the Medicaid and Children’s Health Insurance Program (CHIP) formulary as a payable pharmacy benefit on January 3rd, 2021. Molnupiravir is indicated...

Provider Alert! Pfizer Oral COVID-19 Drug, Paxlovid, Added to Formulary

Date: January 5, 2022 Attention: All Providers Effective Date: December 27, 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: Health and Human Services Commission (HHSC) added Paxlovid to the Medicaid and Children’s Health Insurance Program (CHIP) formulary as a payable pharmacy benefit on December 27,...

Provider Alert!

Provider Alert! Breyanzi available on Medicaid formulary with prior authorization requirements

Date: October 26, 2021 Attention: Oncologists Effective Date: October 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: Prescribers should be aware that Breyanzi (procedure code Q2054) will be available to members through Texas Medicaid pharmacy benefit effective October 1, 2021. Access will require meeting...

Provider Alert!

Provider Alert! Medicaid drug formulary changes effective 1/30/2020

The Texas Vendor Drug Program (VDP) will implement changes to the state Medicaid drug formulary, effective Thursday, January 30, 2020. Select medications will be moving from “preferred” to “non-preferred” status and vice-versa. Texas Children’s Health Plan wanted to notify you in advance so that these changes do not impact the ability of your patients to obtain their medications.  A summary of the changes is included below.   Preferred and non-preferred medications may continue to require clinical prior authorizations. In addition to any...