Tag - HAE

Provider Alert!
09Jun

Provider Alert! Clinical Criteria Revision for Hereditary Angioedema Agents (HAE) effective June 1,2023

Date: June 9, 2023 Attention: All Providers Effective Date: June 1, 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to let providers know that effective June 1, 2023, the Texas Health and Human Services (HHSC) added age and diagnosis restriction for HAE agents. Please see the drugs impacted below: DrugProcedure CodeAgeDiagnosisBerinert®J0597≥ 5 yearsD84.1Kalbitor®J1290≥ 12 yearsD84.1Firazyr®J1744≥ 18 yearsD84.1Takhzyro®J0593≥ 2 yearsD84.1 How this impacts providers: Starting June 1 2023, TCHP will have diagnosis and age restrictions for HAE agents including Berinert®, Kalbitor®, Firazyr® and...

By Facilities, OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , 0 CommentsRead more...
Provider Alert!
11May

Provider Alert! Implementation of Hereditary Angioedema (HAE) Agents Clinical Prior Authorization for Fee for Service Scheduled for April 11

Date: May 10, 2023 Attention: Providers Effective Date: April 11, 2023 Call to action: Effective April 11, 2023 Texas Health and Human Services Commission (HHSC) added Takhzyro generic code (GCN) 39478 to the drugs requiring Hereditary Angioedema (HAE) clinical prior authorization for clients enrolled in Medicaid Fee-For-Service. How this impacts providers: Prescribers will now have to submit a prior authorization for Takhzyro® for their Medicaid fee-for-service population. Next steps for providers: Prescribers should share this communication with their staff. Provider must submit documentation (such as...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , , , 0 CommentsRead more...