Tag - medicaid

Provider Alert!
18Jun

Provider Alert! Drugs Added to Medicaid, CHIP Formularies on June 6, 2024

Date: June 18, 2024 Attention: All Providers Effective date: June 6, 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 June 6, 2024. National Drug CodeDrug NamePDL Status62135099260ZIPRASIDONE HCL 40 MG CAPSULEPDL (preferred)62135099160ZIPRASIDONE HCL 20 MG CAPSULEPDL (preferred)62135099360ZIPRASIDONE HCL 60 MG CAPSULEPDL (preferred)62135099460ZIPRASIDONE HCL 80 MG CAPSULEPDL (preferred)62135004190FOSINOPRIL SODIUM 10 MG TABPDL (preferred)69097099205DILTIAZEM 24H ER(LA) 120 MG TBNPD (non-preferred)69097099305DILTIAZEM 24H ER(LA) 180 MG TBNPD (non-preferred)69097099405DILTIAZEM...

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Provider Alert!
31May

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...

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Provider Alert!
16May

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

Date: May 16, 2024 Attention: Providers Effective date: May 8 and May 10, 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, and May 10, 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 ML SUSP5/10/202400173089713JESDUVROQ 1 MG TABLET5/10/202400173090313JESDUVROQ...

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Provider Alert!
18Mar

Provider Alert! Omnipod 5 Added to Medicaid and CHIP Formularies

Date: March 18, 2024 Attention: All Providers Effective date: February 22, 2024 Call to action: Texas Children’s Health Plan (TCHP) would like to let providers know that effective February 22, 2024, the Texas Health and Human Services (HHSC) allows coverage for Omnipod 5 through pharmacy benefit for both CHIP and Medicaid formularies. Members can obtain one (1) Omnipod 5 G6 intro kit per 365 days, and fifteen (15) units of Omnipod 5 C6 PODS per 30 days. HHSC is not requiring clinical prior...

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Provider Alert!
22Feb

Provider Alert! UPDATED Medicaid Re-enrollment Application Assistance is Available

Date: February 22, 2024 Attention: All Providers Call to action: Texas Children's Health Plan (TCHP) would like to remind providers that continued assistance is available to their patients who need help with their Medicaid Reenrollment Application. Providers should encourage patients with Texas Children’s Health Plan coverage to contact us for assistance and support. How can you help ensure your patients stay covered?  Your continued assistance is crucial to helping your patients maintain coverage so they can access health care. Please ask your patients to:  Make...

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Provider Alert!
13Feb

Provider Alert! 12-Month Postpartum Eligibility Extension for Medicaid and CHIP Pregnant Members

Date: February 13, 2024 Attention: Primary Care, Family Medicine, and Obstetric Care Providers Effective: March 1, 2024 Call to action: Texas Children’s Health Plan (TCHP) would like to share great news with providers about postpartum Medicaid coverage. The Texas Health and Human Services Commission (HHSC) extended postpartum Medicaid coverage from two to 12 months for eligible women, effective March 1, 2024, as part of House Bill 12 (H.B. 12), 88th Legislature, Regular Session, 2023. Also effective March 1, 2024, HHSC will be providing 12...

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Provider Alert!
08Nov

Provider Alert! COVID-19 Vaccine and Vaccine Administration Procedure Codes 91318, 91319, 91320, 91321, 91322, and 90480 Are Now Benefits of Medicaid and CHIP

Date: November 7, 2023 Attention: All Providers Effective for dates of service on or after September 11, 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that in accordance with the U.S. Food and Drug Administration’s amended Emergency Use Authorizations COVID-19 vaccine administration codes for the Pfizer-BioNTech and Moderna COVID-19 vaccines, vaccine procedure codes 91318, 91319, 91320, 91321, 91322, and vaccine administration procedure code 90480 are benefits for Medicaid and CHIP. How this impacts providers: The procedure codes are...

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Provider Alert!
08Nov

Provider Alert! Vaccine Services Benefits Changes for Texas Medicaid

Date: November 6, 2023 Attention: All Providers Effective: October 1, 2023 Call to Action: Texas Children Health Plan (TCHP) would like to let providers know that effective for dates of service on or after October 1, 2023, vaccine services benefits have changed for Texas Medicaid.  On June 27, 2023, the Centers for Medicare & Medicaid Services (CMS) issued guidance on Section 11405 of the Inflation Reduction Act (IRA). Beginning October 1, 2023, statutory amendments made by Section 11405 of the IRA require Medicaid coverage...

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Provider Alert!
11Oct

Provider Alert! New Texas Medicaid & Healthcare Partnership (TMHP) Contracts

Date: October 10, 2023 Attention: All Providers Effective date: September 1, 2023 Call to action: The purpose of this communication is to inform providers that effective September 1, 2023 two new Texas Medicaid and Healthcare Partnership (TMHP) contracts went live: Accenture State Healthcare Services LLC (Accenture) is now the TMHP Business Operations and Business Integration (BusOps) vendor. The TMHP BusOps vendor acts as the project management office across the TMHP vendors and will manage the overall Medicaid ecosystem, including support services such as project management,...

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Provider Alert!
03Oct

Provider Alert! UPDATED Medicaid Re-enrollment Application Assistance is Available

Date: October 3, 2023 Attention: All Providers Call to action: Texas Children's Health Plan (TCHP) would like to remind providers that assistance is available to their patients who need help with their Medicaid Reenrollment Application. Providers should encourage patients with Texas Children’s Health Plan coverage to contact us for assistance and support. In-person application assistance at provider officesIn-office Application Assistance may be available to providers that are interested in supporting the reenrollment process for their patients, pending availability and office location. To...

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