Monthly Archives - October 2022

Provider Alert!

Provider Alert! ANNOUNCEMENT: Member ID Cards

Dear Texas Children’s Health Plan providers, it has been brought to our attention that a small portion of our new members did not receive their current Member ID cards. We have already begun the process of sending the missing ID cards to members and will continue to do so until they are all properly distributed. We ask that you do not turn members away if they cannot present an ID card and instead utilize one of the following ways to...

Provider Alert!

Provider Alert! Change to Signature Requirements for Title XIX (Medicaid) Home Health Services

Date: October 27, 2022 Attention: Home Health Providers Effective date: September 21, 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 purpose of this communication is to inform providers that the Health and Human Services Commission (HHSC) has recently adopted rules in alignment...

Provider Alert!

Provider Alert! Changes to the STAR Kids LTSS Billing Matrix and Crosswalk Effective December 1, 2022

Date: October 27, 2022 Attention: All Providers Effective Date: December 1, 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: UPDATE October 27, 2022: Texas Children’s’ Health Plan (TCHP) would like to communicate with providers that we have worked diligently ahead of the go live date...

Provider Alert!

Provider Alert! EVV Cures Act Home Health Care Services Implementation

Date: October 25, 2022 Attention: STAR Kids Providers/Consumer Directed Services employers, and FMSA Providers Effective date: January 1, 2024 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: Background information: On July 1, 2022, The Health and Human Services commission (HHSC) submitted a good faith effort request to get federal...

Provider Alert! CHIP co-pays waived for office visits in response to COVID-19   

Date: October 26, 2022      Attention: All Providers Effective Date: October 25, 2022  The content in this message will remain in effect through November 30, 2022 as announced by the Health and Human Services Commission. TCHP 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 to the...

Provider Alert!

Provider Alert! Clinical Criteria Update for Orkambi Effective November 9

Date: October 25, 2022 Attention: Providers Effective Date: October 1, 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: Texas Children Health Plan (TCHP) will revise clinical prior authorization criteria for Orkambi (lumacaftor/ivacaftor) to comply with the recent Food and Drug Administration-approved age indications. How this impacts...

Provider Alerts! Cosentyx Clinical Prior Authorization Criteria Revision Scheduled for November 22

Date: October 25, 2022 Attention: Providers Effective Date: October 1, 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: Texas Children Health Plan (TCHP) will revise clinical prior authorization criteria for Cosentyx to comply with the recent Food and Drug Administration-approved age indications. How this impacts providers:...

Provider Alert!

Provider Alert! Potential Electronic Visit Verification Changes Coming in 2023 

Date: October 19, 2022 Attention: STAR Kids Providers/Consumer Directed Services employers, and FMSA Providers Expiration date for current EVV vendors: August 31, 2023 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 would like to notify providers that Health and Human Service...

Provider Alert!

Provider Alert! ProAir® HFA Inhaler Discontinuation

Date: October 17, 2022 Attention: All Providers Effective Date: October 1, 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: Texas Children’s Health Plan (TCHP) would like to let providers know that the ProAir® HFA inhaler, one of many preferred asthma inhalers, was discontinued by...

Provider Alert!

Provider Alert! RSV Fall/Winter Traditional Season Regional Changes Begin October 17

Date: October 17, 2022 Attention: All Providers  Effective Date: October 17, 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: Traditional Respiratory Syncytial Virus (RSV) season is here. Texas Children’s Health Plan (TCHP) would like to let providers know that effective October 17, 2022, the Texas...