Author - Texas Children's Health Plan

Provider Alert!
29Jun

Provider Alert! Case Management for Children and Pregnant Women (CPW) Carve-In Reminder

Date: June 29, 2023 Attention: All Providers Call to action: The purpose of this communication is to remind providers of the Case Management for Children & Pregnant Women (CPW) carve-in to Medicaid that became effective September 1, 2022. Background: House Bill 133, 87th Legislature, Regular Session, 2021, requires the case management for children and pregnant women benefit to be carved-in to Medicaid managed care, which means Medicaid managed care organizations like Texas Children’s Health Plan (TCHP) will contract with and reimburse providers...

By Provider Alert, 0 CommentsRead more...
Provider Alert!
28Jun

Provider Alert! UPDATED: New EVV Vendor System HHAeXchange Launching October 1, 2023

Date: June 28, 2023 Attention: All Providers Effective Date: October 1, 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that a new single state funded Electronic Visit Verification (EVV) vendor system, HHAeXchange, is launching October 1, 2023. On April 26, 2022, the Texas Health and Human Services Commission (HHSC) posted a solicitation for EVV System Management Services. Through a competitive selection process, HHSC has selected Accenture State Healthcare Services LLC. How this impacts providers: Accenture will continue to...

By Uncategorized, 0 CommentsRead more...
19May

Alert Provider! Change in PDL Status for the Smoking Cessation Drug Class Effective May 16, 2023

Date: May 18, 2023 Attention: All Providers Effective Date: May 16, 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to let providers know that effective May 16, 2023, Texas Health and Human Services Commission (HHSC) removed non-preferred status from the generic product, varenicline, to the preferred drug list (PDL). The preferred status of the brand product Chatnix® (NDC 00069-0468-56, 00069-0471-03, 00069-0469-56) will not change. This is in response to drug shortage for the brand Chantix® due to a...

By Provider Alert0 CommentsRead more...
19May

Provider Alert! REMINDER: Federal Public Health Emergency Ended May 11, 2023 – Update on COVID Flexibilities

Date: May 19, 2023 Attention: All Providers Call to action: The Health and Human Services Commission (HHSC) updated the COVID flexibilities with several new updates since March 2023 as a result of the public health emergency (PHE) ending. This includes the following: HHSC to End Telephone (Audio-only) Medical Services COVID-19 Guidance and Issue Temporary Guidance for Certain Audio-Only Services Infection Control Supplies Procedure Code S8301 No Longer a Benefit Effective May 12, 2023 Advance Notice of Requirements for the Use of Telecommunications for Service...

By Provider Alert0 CommentsRead more...
19May

Provider Alert! Clarifying Information on Provider Enrollment and Management System (PEMS)

Date: May 18, 2023 Attention: All Providers Master Provider File effective date: To Be Determined Important provider notice: As a reminder, the Provider Enrollment and Management System (PEMS) is the required Texas Medicaid & Healthcare Partnership (TMHP) program which is the single tool for provider enrollment, reenrollment, revalidation, and maintenance requests (maintaining and updating provider enrollment record information) for Texas Medicaid. Clarifying information on PEMS can be found here: https://www.tmhp.com/news/2023-05-16-provider-enrollment-and-management-system-pems-post-deployment-update Providers are strongly encouraged to visit this site for an overview of...

By Provider Alert0 CommentsRead more...
19May

Provider Alert! Important Reminder about Medicaid Re-enrollment and How Providers Can Assist Their Patients

Date: May 19, 2023 Attention: All Providers Effective Date: Ongoing Call to action: Texas Children’s Health Plan (TCHP) would like to remind providers that the Medicaid coverage rules have changed, and some Medicaid recipients will need to go through the renewal process to determine their eligibility for coverage. This is the result of the Consolidated Appropriations Act, 2023 (CAA, 2023) that was enacted on December 29, 2022. The CAA ended the auto-renewals for Medicaid. Starting April 2023, some of our Texas Children’s Health...

By Provider Alert0 CommentsRead more...
17Mar

Provider Alert! Medicaid Coverage Changes Are Coming- How Providers Can Assist Their Patients and What Steps Texas Children’s Health Plan (TCHP) is taking to Help Members

Date: March 17, 2023 Attention: All Providers Coverage change effective date: April 1, 2023 Call to action: As you may know, the Medicaid and/or CHIP coverage rules will soon be changing and all members will need to go through the process to determine their eligibility for coverage. Beginning, April 1, 2023, some of our members will be required to renew their Medicaid and/or CHIP coverage or risk losing their plan and access to healthcare. Others will have to go through this process...

By Provider Alert0 CommentsRead more...
15Mar

Provider Alert! Subject: Respiratory Syncytial Virus (RSV) Season Ended on March 1

Date: March 14, 2023 Attention: Providers Effective Date: March 1, 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: Effective March 1, 2023, the Texas Health and Human Services (HHSC) closed Respiratory Syncytial (RSV) season’s Synagis prophylaxis therapy in all regions. This is in response...

By Provider Alert0 CommentsRead more...
15Mar

Provider Alert! TCHP Psychotropic Medication Utilization Review (PMUR

Date: March 14, 2023 Attention: Pediatricians, Psychiatrists Call to action: Texas Children’s Health Plan (TCHP) utilizes a PMUR program to promote safe prescribing of behavioral health medications to children and adolescents. TCHP identifies potential “prescribing outliers” using parameters established by the Texas Health and Human Services (HHSC). This does not mean the prescribing is wrong or harmful to the child, but requires additional review due to potential for adverse reactions, polyprescribing, and other implications. Who is identified for review? Members under the age of...

By Provider Alert, Uncategorized0 CommentsRead more...
11Jan

Provider Alert! NEW Texas Children’s Health Plan Website

Date: January 10, 2023 Attention: All Providers Launch date: Friday, January 13, 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: At Texas Children’s Health Plan (TCHP), we are constantly looking for ways to improve our provider experience and on Friday, January 13, 2023 we will...

By Provider Alert0 CommentsRead more...