Tag - VDP

Provider Alert!

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...

Provider Alert!

Provider Alert! September 2023 Specialty Drug List Now Available

Date: September 28, 2023 Attention: All Providers Call to action: The September 2023 Biannual Specialty Drug List (SDL) is now available from the vendor drug program website. How this impacts providers: Providers should refer to the vendor drug program for more information about drugs covered on the SDL. Next step for Providers: Prescribers should share this update with their staff. If you have any questions, please email Provider Relations at: providerrelations@texaschildrens.org.For access to all provider alerts,log into:www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.

Provider Alert!

Provider Alert! HHSC to Implement Gattex® Clinical Prior Authorization on June 6, 2023

Date: May 31, 2023 Attention: All Providers Effective Date: June 6, 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to let providers know that effective June 6, 2023, Texas Health and Human Services (HHSC) will be implementing the Gattex® clinical prior authorization criteria, which was approved on April 28, 2023. How this impacts providers: Starting June 6, 2023, TCHP will implement the Gattex® clinical prior authorization criteria. The new criteria is available on the HHSC Vendor Drug Program website and can...

Provider Alert!

Provider Alert! Subject: Unclassified Medical Drugs Prior Authorization Requirement

Date: May 8, 2023 Attention: All Providers Effective Date: June 8, 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that effective June 8 2023, medical claims under $5,000 submitted to TCHP with unclassified Healthcare Common Procedure Coding System (HCPCS) code J3490 will no longer require a pre-service (prior authorization) request as claims above this cost will be subject to clinical necessity review by the pharmacy team. This dollar limit does not apply to other unclassified codes J9999, J3590,...

Provider Alert!

Provider Alert! September 2022 Specialty Drug List Available

Date: October 11, 2022 Attention: All Providers Effective Date: September 28, 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 September 2022 Biannual Specialty Drug List (SDL) is now available from the vendor drug program website. How this impacts providers: Providers should refer to the vendor...

Provider Alert!

Provider Alert! Medicaid Preferred Drug List and Formulary Changes

Date: September 14, 2022 Attention: All Providers Effective Date: July 28, 2022 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with 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 the Texas Vendor Drug Program (VDP) implemented changes to the state Medicaid drug formulary,...

Provider Alert!

Provider Alert! RSV Summer Season Changes Begin September 1

Date: September 13, 2022 Attention: All Providers Effective Date: September 1, 2022 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with 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 the Health and Human Services Commission (HHSC) will close the 2022 Respiratory Syncytial Virus...

Provider Alert!

Provider Alert! Medicaid Preferred Drug List and Formulary Changes

Date: July 6, 2022 Attention: All Providers Effective Date: July 28, 2022 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with 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 the Texas Vendor Drug Program (VDP) implemented changes to the state Medicaid drug formulary, effective...

Provider Alert!

Provider Alert! Medicaid Preferred Drug List and Formulary Changes

Date: January 25, 2022 Attention: All Providers Subject: Medicaid Preferred Drug List and Formulary Changes Effective Date: January 27, 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 Texas Vendor Drug Program (VDP) implemented changes to the state Medicaid drug formulary, effective Thursday, January 27, 2022....

Provider Alert!

Provider Alert! 2021-2022 Respiratory Syncytial Virus Season and Synagis (palivizumab)

Date: July 23, 2021 Attention: All Providers Treatment start date: October 1, 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. **This notice may be updated as new regions are opened or closed Call to action: The traditional 2021-22 Respiratory Syncytial Virus (RSV) season is here! The Texas RSV Region...