Tag - provider alert
10Feb

Provider Alert! COVID-19 Vaccine Administration Procedure Code 0073A is now a Benefit

Date: February 9 , 2022  Attention: All Providers    Effective date: January 3, 2022 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: Effective for dates of service on or after January 3, 2022, COVID-19 vaccine administration code 0073A is a benefit of Medicaid and CHIP...

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25Jan

Provider Alert! Merck Oral COVID-19 drug, Molnupiravir, Added to Formulary

Date: January 24, 2022 Attention: Primary care providers Effective Date: January 3, 2022 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: HHSC added Molnupiravir to the Medicaid and Children’s Health Insurance Program (CHIP) formulary as a payable pharmacy benefit on January 3rd, 2021. Molnupiravir is indicated...

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Provider Alert!
25Jan

Provider Alert! HHSC Interoperability and Health Information Exchange Survey for Behavioral Health Providers Open

Date: January 25, 2022 Attention: Behavioral Health Providers Survey will be available: January 24, 2022 thru February 18, 2022 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 intent of this survey is to gather information on the interoperability needs and technology readiness of behavioral health...

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19Jan

Provider Alert! Signature Requirement Reinstated on DME Forms

Date: January 19, 2022 Attention: DME Providers Subject: Signature Requirement Reinstated on DME Forms TCHP COVID-19 Utilization Management Procedure and TCHP provider alerts can be found here: http://www.thecheckup.org/provider-alerts/ TCHP network providers should monitor the 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: Effective January 1, 2022, a member or member’s authorized representative’s signature is required on DME...

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Provider Alert!
14Jan

Provider Alert! Prior Authorization Criteria for Benlysta (J0490)

Date: January 14, 2022 Attention: Oncology Providers Effective Date: March 1, 2022 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: Beginning March 1, 2022, Benlysta (procedure code J0490) will be available for Medicaid members as a medical benefit. Benlysta (belimumab) is indicated to treat active, autoantibody-positive,...

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Provider Alert!
14Jan

Provider Alert! Stimate Nasal Spray National Drug Shortage

Date: January 14, 2021 Attention: All Providers Subject: Stimate Nasal Spray National Drug Shortage Effective date: December 16, 2021 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 Texas Health and Human Services Comission (HHSC) was made aware of a voluntary recall issued by Ferring Pharmaceuticals for...

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Provider Alert!
14Jan

Provider Alert! Prior Authorization Criteria for Saphnelo (C9086)

Date: January 14, 2022 Attention: Oncology Providers Effective Date: March 1, 2022 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: Beginning March 1, 2022, Saphnelo (procedure code C9086) will be available for Medicaid members as a medical benefit. Saphnelo (anifrolumab-fnia) is indicated to treat moderate to...

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06Jan

Provider Alert! Pfizer Oral COVID-19 Drug, Paxlovid, Added to Formulary

Date: January 5, 2022 Attention: All Providers Effective Date: December 27, 2021 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: Health and Human Services Commission (HHSC) added Paxlovid to the Medicaid and Children’s Health Insurance Program (CHIP) formulary as a payable pharmacy benefit on December 27,...

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20Dec

Provider Alert! CHIP Perinatal Members Eligible for COVID-19 Vaccine

Date: December 20, 2021 Attention: All Providers Effective Date: December 11, 2021 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: Effective December 11, 2020, CHIP Perinate members enrolled in CHIP Perinatal services are eligible to receive the COVID-19 vaccine. The CHIP Perinatal (CHIP-P) Program serves the...

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Provider Alert!
08Dec

Provider Alert! Clinical Prior Authorization Criteria Update for Repatha (evolocumab)

Date: December 7, 2021 Attention: Primary Care Providers Effective Date: December 6, 2021 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 Medicaid will update the clinical prior authorization criteria for Repatha (evolocumab) to reflect the recent FDA-approved age expansion. How this impacts providers: Effective December 6,...

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