Provider Alert! Removal of Specialist Requirement from Clinical Prior Authorization CriteriaTexas Children's Health Plan
Date: January 28, 2022
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 January 3, 2022, HHSC removed the specialist requirement from the following clinical prior authorization criteria:
- CGRP Antagonist, Acute
- CGRP Antagonists, Chronic
- Ophthalmic Immunomodulators
- Transthyretin Agents
- VMAT2 Inhibitors
How this impacts providers: Providers will need to use updated prior authorization forms and communicate these changes to their staff.
Navitus TX Medicaid Prior Authorization Forms
If you have any questions, please email TCHP PharmacyDepartment at: TCHPPharmacy@texaschildrens.org.
For access to all provider alerts, log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.
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