Tag - provider alerts

Provider Alert!
15May

Provider Alert! Continuing Education credit: Transition Services for Children and Youth with Special Health Care Needs

Attention Primary Care Providers Effective Date: May 15, 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: Primary Care Providers that care for members with special health-care needs are encouraged to participate in this online course provided by the Health and Human Services Commission (HHSC)...

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07May

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 pharmacy...

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Provider Alert!
07May

Provider Alert! Provider Incentive Program Updates

Attention: All PCP Providers Effective Date: May 7, 2020 Call to action: Texas Children’s Health Plan (TCHP) would like to inform you of changes to our Provider Incentive Program (PIP) Upper Respiratory Infection measure to align with the changes consistent with National Committee for Quality Assurance (NCQA) HEDIS technical specifications. The Health and Human Services Commission (HHSC) follows this guidance as well in their oversight of Managed Care Organizations. How this impacts providers: Updates include the following for measure, Appropriate Treatment for Upper...

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17Apr

Provider Alert! Association for Community Affiliated Plans (ACAP) webinar on small business relief

Attention: All Providers Effective: April 15, 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: TCHP would like to extend an invitation to our network providers to attend a webinar on COVID-19 small business relief on Tuesday, April 28, 2020 at 2:00PM CST. The Association...

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Provider Alert!
08Apr

Provider Alert! FDA removing all ranitidine products from the market

Attention: All Providers and Pharmacies Effective Date: April 2, 2020 Call to action: The FDA announced it is requesting manufacturers withdraw all prescription and over-the-counter (OTC) ranitidine drugs from the market immediately. This is the latest step in an ongoing investigation of a contaminant known as N-Nitrosodimethylamine (NDMA) in ranitidine medications (commonly known by the brand name Zantac). The agency has determined that the impurity in some ranitidine products increases over time and when stored at higher than room temperatures and may result in...

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07Apr

Provider Alert! COVID-19 Disaster Declaration – ALERT #3 – Prior Authorization Adjustments

Attention: All Providers Effective Date: April 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: As are result of the COVID-19 Disaster Declaration, TCHP has instituted the following changes to our authorization procedures. This alert is an update to our alert on April 2, 2020...

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Provider Alert!
06Apr

Provider Alert! Attention: Early Childhood Intervention (ECI) Providers

Attention: Early Childhood Intervention (ECI) Providers Effective Date: April 3, 2020 Call to action: In accordance with guidance from Texas Medicaid Provider Procedures Manual (TMPPM), providers must use the associated benefit code when submitting claims. How this impacts providers: Changes in billing practices may be required if there are claim denials. Next steps for providers: Billing reminders: Providers should ensure that their claims submissions include their benefit code per TMHP guidelines. If the taxonomy code is attested to a benefit code, the benefit code should be...

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Provider Alert!
03Apr

Provider Alert! Patient Lifts

Attention: Primary Care and DME Providers Effective Date: July 3, 2020 Call to action: In accordance with Texas Medicaid Provider Procedure Manual (TMPPM), patient lifts will require prior authorization, except for E0637 & E0641when billed outside of the benefit limitations.  Click here for the Prior Authorization Form. Coding information for lifts as an addition to the mobility aids that are already on the Prior Authorization list. Code Explanation E0630* Hydraulic//mechanical lift. This code has a limit of 1 purchase every 5 years and 1 month rental. E0635* Portable lift....

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03Apr

Provider Alert! COVID-19 Guidance: UPDATE ALERT #5 Telehealth Services: Targeted Case Management through remote delivery

Attention: Behavioral Health, OB/GYN, and ECI Providers Effective Date: April 24, 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:  TCHP supports Texas Medicaid Healthcare Partnership (TMHP) guidance on Targeted Case Management. This service may be delivered through synchronous audio-visual technologies or telephone (audio-only). Providers should...

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24Mar

Provider Alert! Select an EVV Vendor System or EVV Proprietary System Update

Attention: Financial Management Services Agencies (FMSA) Effective Date: May 1, 2020 Due to impacts of coronavirus, HHSC is extending the deadline to May to select an EVV system and begin the onboarding process. The original deadline was April 1,2020. Therefore, Financial Management Services Agencies (FMSAs) must select an Electronic Visit Verification or EVV Vendor System or EVV Proprietary System by May 1, 2020. How this impacts providers: All FMSAs currently contracted with MCOs or the Texas Health and Human Services Commission (HHSC).   Next steps for...

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