Tag - medicaid

Provider Alert!

Provider Alert! Medicaid, STAR Kids, CHIP, and CHIP Perinatal eligibility during COVID-19

Attention: All Providers Effective Date: July 31, 2020 – January 21, 2021 The content in this message will remain in effect through the public health emergency period, extended to January 21, 2021, as announced by the U.S. Health and Human Services Department. TCHP COVID-19 Utilization Management Procedure and TCHP provider alerts can be found here: http://www.thecheckup.org/provider-alerts/ 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 [...]

Provider Alert!

Provider Alert! Texas Medicaid and CHIP Immunization Alert – Vaccines for Specific Ages

table { border-collapse: collapse; }tr,td { border: solid thin; } Date: September 29, 2020 Attention: All Providers 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 Center for Disease Control and Prevention (CDC) recommends the following vaccines for children and adolescents.  Please refer to [...]

Provider Alert!

Provider Alert! Guidance for Laxatives for Medicaid Members

table { border-collapse: collapse; }tr,td { border: solid thin; } Attention: All Providers Effective Date: September 3, 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: Polyethylene Glycol [PEG] 3350 (generic for Miralax), ClearLax (powdered formulation of PEG 3350) and generic lactulose are all [...]

Provider Alert!

Provider Alert! Hurricane Laura and Delta Information for Medicaid Providers

Date: October 12, 2020      Attention: All Medicaid Providers 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 our network Medicaid providers of new guidance from the Health and Human Services Commission (HHSC) regarding coverage. Texas providers [...]

Provider Alert!

Provider Alert! Ambulatory and Long-Term Electroencephalogram Benefits Changing for Texas Medicaid

table { border-collapse: collapse; }tr,td { border: solid thin; } Attention: All Providers        Effective Date: October 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) would like to inform providers that effective for dates of service on or [...]

Provider Alert!

Provider Alert! Updates to the Texas Medicaid Provider Procedures Manual

Attention: Radiologists, Cardiologists, Imaging Services, Ophthalmologists, Optometrists Effective Date: August 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) aligns with the Texas Medicaid Healthcare Partnership (TMHP) regarding the benefit criteria in the Medical and Nursing Specialists, [...]

Provider Alert!

Provider Alert! New Federal Enhanced Provider Relief Funds for Medicaid and CHIP Providers

Attention: All Providers Effective Date: June 10, 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) would like to inform you of new federal Enhanced Provider Relief Funds for Medicaid and CHIP providers. Here are the details: Beginning June 10, [...]

Provider Alert! COVID-19 Medicaid Pharmacy Benefit Updated May 4, 2020

Attention: All Providers and Pharmacies Effective Date: May 4, 2020 The Texas Vendor Drug Program (VDP) has implemented several changes in response to COVID-19. This notice contains the latest updates, as well as links to the previously implemented changes. No-auto prior authorization (NAP) designation temporarily lifted: Normally, medications listed as NAP on the drug formulary by VDP require a manual hard stop in the system. Providers must call/fax to complete a prior authorization (PA) rather than allowing automated authorizations by reviewing historical [...]

What is the role of STAR Kids Service Coordinators?

A Service Coordinator is the central contact between Texas Children’s Health Plan and a member’s providers and family members. The purpose of a Service Coordinator is to maximize a Member’s health, wellbeing and independence. The Service Coordinator must work with the Member’s PCP to coordinate all of a member’s health services. The STAR Kids Service Coordinator also engages as an advocate and intervenes on behalf of the member if approved by the member. The Service Coordinator will perform an overall [...]