Provider Alert! Novavax COVID-19 Vaccine Coverage Update

Date: July 29, 2022

Attention: All Providers

Effective date: July 13, 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 on July 13, 2022, the U.S. Food and Drug Administration (FDA) issued an emergency use authorization (EUA) for the Novavax COVID-19 vaccine for individuals 18 and older.

How this impacts providers: The Health and Human Services Commission (HHSC) allows for pharmacy benefit coverage of the Novavax COVID-19 vaccine in compliance with the EUA issued by the FDA. The Novavax COVID-19 vaccine is given as a two-dose primary series three weeks apart.

Effective July 13, 2022, HHSC will cover the Novavax COVID-19 Vaccine NDCs in the table below for Medicaid and CHIP as a payable pharmacy benefit.

Next steps for providers: Providers are encouraged to share this communication with their staff and TCHP members as an available pharmacy benefit for COVID-19 vaccination for members 18 years and older.

Providers should educate themselves on the recommendations for Novavax COVID-19 vaccine as a primary series to support eligible TCHP member needs. Multiple resources are available on the CDC website including the linked CDC webinar and Novavax product information below:

Webinar Thursday, July 28, 2022 – Recommendations for the Novavax COVID-19 Vaccine Primary Series in Adults Ages 18 Years and Older (cdc.gov) – Novavax COVID-19 Vaccine | CDC

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.