Tag - provider alert

Provider Alert!

Provider Alert! Updated Wheelchair Guidelines

Call to action: The purchase of a wheelchair is a benefit every five years, with the following guidelines: For current members who are twelve years of age and younger: The wheelchair frame must allow for at least a 3-inch growth potential in both width and depth. For current members who are 13 through 17 years of age: The wheelchair frame must allow for at least a 2 inch growth potential in both width and depth. For current members who are 18 years [...]

Provider Alert!

Provider Alert! Mandatory HHSC training for Financial Management Services Agencies (FMSA)

Effective February 25, 2020 Call to action: Health and Human Services Commission (HHSC) is providing a webinar for Financial Management Services Agencies (FMSAs) scheduled for Tuesday, February 25th, beginning at 1:30 P.M until 3:00 P.M. How this impacts providers: All FMSAs currently contracted with MCOs or HHSC must attend this training. Next steps for providers: FMSA providers should register for the training at: https://register.gotowebinar.com/register/2102807596481100801 The topics covered in the webinar will include: Consumer Directed Services updates and reminders Electronic Visit Verification updates Texas Workforce Commission updates   If [...]

Provider Alert!

Provider Alert! URGENT – Makena (hydroxyprogesterone caproate) formulary change

Attention: OB providers Subject: URGENT - Makena (hydroxyprogesterone caproate) formulary change Effective Date: January 30, 2020   Call to action: The Texas Vendor Drug Program (VDP) will implement changes to the state Medicaid drug formulary, effective Thursday, January 30, 2020. Brand Makena formulations (intramuscular solution for injection, and subcutaneous auto-injectors) will remain on the preferred drug list (PDL). VDP has moved all generic hydroxyprogesterone caproate formulations to non-preferred drug status. Compounded formulations are not covered under the Medicaid formulary. Medicaid managed care plans are [...]

Provider Alert!

Provider Alert! TCHP Fax Lines Availability: Fax lines open 24/7

Date: January 16, 2020 Attention: TCHP Providers Effective Date: January 6, 2020 Call to action: We are excited to announce that Texas Children’s Health Plan has made updates to the availability of the fax lines for authorization requests. The following outlines a summary of the changes. Beginning January 6, 2020, TCHP fax lines are open to receive requests for authorizations 24/7. This is a change to the former procedure to receive faxed requests for authorizations during normal business hours (Monday-Friday, 8a.m. – 6p.m.). Now [...]

Provider Alert!

Provider Alert! Update: Acute Therapy Requests with treatment for less than 60 days, a Texas Health Steps Checkup or Attestation is Not Required

Effective Date: October 31, 2019   Initial specialty therapy (occupational, physical, speech therapy) evaluations do not require prior authorization effective September 1, 2019. However, a current Texas Health Steps checkup performed in the last 12 months or a current well checkup attestation is required for ongoing specialty therapy lasting for greater than 60 days.   How this impacts providers: In an effort to ensure our in-network providers can provide specialty therapy evaluations within 21 days of submission of a signed referral, Texas Children’s [...]

Provider Alert!

Provider Alert! Texas Department of State Health Services (DSHS) Laboratory Web Portal

On October 25th, it was reported that the laboratory web portal application for public health experienced unexpected technical difficulties. It is currently not available and as a result, the provider report cards are unavailable at this time. While DSHS Laboratory is actively working on a solution, there is not a date for when the matter will be resolved. How this impacts providers: Texas Health Step Providers that normally receive results via the Laboratory Web Portal will have the reports mailed [...]

Provider Alert!

Provider Alert! Syphilis testing laws updated effective 9/1/2019

Texas law now mandates three syphilis tests for all pregnant women: at the first prenatal exam, during the third trimester (no earlier than 28 weeks gestation), and at delivery.  This new testing is required because congenital syphilis cases reported to the Texas Department of State Health Services (DSHS) more than doubled last year.  There were 367 cases of congenital syphilis in Texas in 2018, up from 164 in 2017. The increase in reported cases is likely due to a [...]

Provider Alert!

Provider Alert! Reimbursement Rate Changes for PCS, PDN & Therapy Services

Date: October 16, 2019 Attention: Home Health, Therapy and LTSS Providers Subject: Reimbursement Rate Changes for PCS, PDN & Therapy Services Effective Date: September 1, 2019 Call to action: On August 28, 2019, Texas Children’s Health Plan (TCHP) received notice of the rate changes from Texas Medicaid Healthcare Partnership (TMHP) effective September 1, 2019.  The services impacted by the Medicaid-implemented rate changes include: Personal Care Services (PCS) Private Duty Nursing (PDN) Therapies for Children in the Home Therapy Assistants TCHP is in the process of implementing the updates [...]