Monthly Archives - June 2020
29Jun

Provider Alert! Service Planning for Pregnant Women during COVID-19

Attention: OB/GYN Providers Effective Date: June 26, 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. The content in this message will remain in effect throughout the COVID-19 Disaster Declaration period as announced by the office of the Texas Governor, Greg Abbott.  COVID-19 Utilization Management Procedure and provider...

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27Jun

Provider Alert! MDCP Interest List Releases postponed through COVID-19 Disaster Declaration Period

Attention: STAR Kids Providers Effective Date: June 26, 2020 The content in this message will remain in effect throughout the COVID-19 Disaster Declaration period as announced by the office of the Texas Governor, Greg Abbott. COVID-19 Utilization Management Procedure and provider alerts can be found here: http://www.thecheckup.org/provider-alerts/ 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...

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25Jun

Provider Alert! COVID-19/Pharmacy Revised Update from June 8, 2020

Attention: All Providers and Pharmacies Effective Date: June 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: The Food and Drug Administration (FDA) has removed the emergency use authorization of hydroxychloroquine (HCQ) and chloroquine due to controlled studies showing no evidence of benefit for mortality...

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Provider Alert!
24Jun

Provider Alert! Prosthetics Codes Prior Authorization Requirements

Attention: Prosthetics, DME providers, orthopedists, podiatrists, PCPs Effective Date: June 3, 2020 Call to action: Texas Children’s Health Plan (TCHP) aligns with Texas Medicaid Provider Procedures Manual (TMPPM) and requires prior authorization for prosthetics procedures codes. How this impacts providers: Provider offices should utilize the Standard Prior Authorization Form for prosthetics. References: TCHP Prior Authorization Requirements TCHP Prosthetics Guidelines Next steps for providers: Providers should reference the prosthetic procedure codes according to TMPPM section 2.2.19.2 Prior Authorization and Documentation Requirements. If you have any questions, please email Provider Network...

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Provider Alert!
24Jun

Provider Alert! Prior Authorization guidelines for Manual Wheelchair Accessory Code E2227

Attention: All Providers Effective Date: June 23, 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) aligns with the Texas Medicaid Provider Procedures Manual (TMPPM) regarding the authorization requirements for Code E2227, manual wheelchair accessory, and gear reduction drive wheel,...

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Provider Alert!
24Jun

Provider Alert! Update: Prior Authorization Criteria for Brexanolone (Zulresso)

Attention: : Behavioral Health and Obstetric care providers Effective Date:  July 1, 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) would like to inform you of a new benefit for members and an update to the prior authorization criteria for brexanolone...

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Provider Alert!
24Jun

Provider Alert! Speech generating software authorization reminder

Attention: Speech Therapists Effective Date: June 23, 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) would like to inform you that we align with Texas Medicaid Provider Procedure Manual (TMPPM) regarding the guidelines for Code E2511, Speech generating software program, for...

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Provider Alert!
24Jun

Provider Alert! Benralizumab, Mepolizumab, and Omalizumab Benefits in the Home Setting

Attention: Pulmonologists, Allergists, and DME Providers Effective Date: For dates of service on or after June 1, 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) aligns with the new guidelines from the Health and Human Services Commission (HHSC) for dates of...

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Provider Alert!
23Jun

Provider Alert! Authorization update for orthoses devices and related services

Attention: DME providers, orthopedists, podiatrists, PCPs Effective Date: September 5, 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) would like to inform providers of the authorization requirements for custom fitted orthoses devices.  Certain prefabricated orthoses devices for acute injury...

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Provider Alert!
18Jun

Provider Alert! Home Health DME and Supplies Exceptional Circumstances Provision for Medicaid Members 21 years of age and older

Attention: DME Providers Effectvie Date: June 1, 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 aligns with the Texas Medicaid and Healthcare Partnership (TMHP) new guidance for Durable Medical equipment (DME) and supplies under exceptional circumstances. Effective June 1, 2020...

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