Provider Alert! Pharmacy Updates Related to COVID-19

Attention: All Providers and Pharmacies
Effective Date: March 20, 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: Texas Children’s Health Plan (TCHP) supports member access to medications with guidance from Texas Health and Human Services Commission (HHSC) and Texas State Board of Pharmacy during the disaster declaration period.

90 day fills: Ninety (90)-day fill requests will be honored at the dispensing pharmacist’s discretion if the following conditions are met:

• there are sufficient fills/quantities remaining on the prescription
• the prescriber has not indicated the patient is ineligible for 90 day fills
• the pharmacist notifies the prescriber of the change
• the request complies with Texas Board of Pharmacy restrictions

Emergency fill authorization: On March 20th, the Texas State Board of Pharmacy in response to the  disaster declaration for COVID-19 authorized pharmacists in Texas to dispense up to a 30-day supply of medication (except schedule II-controlled substances) without requiring authorization from a prescriber. Pharmacists may choose to extend a refill for the medication without authorization if they believe failure to continue therapy may result in patient harm or suffering.

Potential drug shortages: hydroxychloroquine, chloroquine, mefloquine, and azithromycin: In response to the potential for extreme supply chain shortages, the Texas State Board of Pharmacy issued an emergency rule on March 20th restricting its use. Pharmacies are to follow these guidelines:

• not to dispense the medication without a diagnosis on the prescription consistent with evidence for its use
• limit fills to a 14-day supply unless the patient was previously established on therapy prior to March 20^th
• refills may not be permitted without a new prescription

Potential drug shortages: short acting beta agonists (SABA) bronchodilators: Due to possible drug shortages for these medications, HHSC moved several bronchodilators from non-preferred to preferred status. This includes levalbuterol, Xopenex, and ProAir Respiclick products. The full list of National Drug Codes can be found on the HHSC website.

How this impacts providers: COVID-19 may impact the pharmacy supply chain for the above named drugs. Prescribers should ensure members have sufficient supply on hand, but also discourage unnecessary overutilization of early refills or ninety (90) day fills. Several pharmacies still offer free delivery services to members, and can continue to provide normal fills.

Next steps for providers: The Vendor Drug Program asks providers to complete the Drug Shortage Notification Form (Form 1315), so HHSC can be aware of potential shortages that would affect prescribing choice or pharmacy supply. This process allows for notification of drug alternatives when the supply is low, timeline for the shortage, and the drug’s availability for use.

If you have any questions, please email Provider Network Management at: providerrelations@texaschildrens.org.

For access to all provider alerts, log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.