hematology – The Checkup

Provider Alert! Prior authorization update for Reblozyl, procedure code J0896

Attention: Hematologists Effective Date: September 1, 2020 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) will align the prior authorization requirements for Reblozyl with Texas Medicaid Healthcare Partnership (TMHP) guidance. A prior authorization will be required beginning September 1, 2020. Resources: TMHP...

Provider Alert! Adakveo Update

Attention: Hematologists Effective Date: May 26, 2020 Call to action: Adakveo, Injection, crizanlizumab - clinician administered drug HCPCS code C9053 is an at risk drug. Currently, there is no prior authorization required; however, beginning May 26, 2020 authorization guidelines will be in place. The required criteria to receive Adakveo include: HbSS (sickle cell) diagnosis Patients over the age of 16 years-old Patients that have experienced more than two vaso-occlusive crisis (VOC) events in the past 12-months How this impacts providers: Prescribers should adhere to the guidelines and acquire...

Tag - hematology