Author - Texas Children's Health Plan

Provider Alert!
23Mar

Provider Alert! New “Black Box” warning for Singulair (montelukast) and generic formulations

Attention: PCPs, Pulmonologists, and Pharmacists Effective Date: March 20, 2020 After careful analysis of the benefits and risks, the Food and Drug Administration (FDA) has strengthened the existing warnings on potential side effects on all Singulair and generic montelukast formulations. A “Black Box” warning has been included to stress the potential for serious side effects, including but not limited to serious behavior and mood-related changes. The FDA has also advised restricting the use for allergic rhinitis (hay fever) to those not treated...

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19Mar

Provider Alert! COVID-19 Disaster Declaration – Texas Children’s Health Plan Operational Adjustments

Attention: All Providers Effective Date: March 13, 2020 TCHP affiliated providers should monitor the 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: Reporting adjustments to normal provider business operations Texas Children’s Health Plan has developed a provider notification survey which is posted on the Provider portal www.texaschildrenshealthplan.org/for-providers and the website. This survey allows providers to...

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19Mar

Provider Alert! COVID-19 Disaster Declaration – Prior Authorization Adjustments

Attention: All Providers Effective Date: March 18, 2020 TCHP affiliated providers should monitor the 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: As are result of the COVID-19 Disaster Declaration, TCHP has instituted the following:   In order to increase access to primary care services, TCHP is now waiving prior authorization requirements for out-of-network primary care...

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18Mar

Provider Alert! Update – Telemedicine & Telehealth Services and COVID-19

Attention: All Providers Effective Date: March 17, 2020 Texas Children’s Health Plan supports the delivery of telemedicine and telehealth services to its members. As part of our COVID-19 Emergency Response, Texas Children’s Health Plan will add coverage of telemedicine services that are provided through only synchronous audio interactions (audio-only telephone consultation). How this impacts providers: Telemedicine services should be provided in compliance with standards established by the respective licensing or certifying board of the professional providing the services. While telemedicine services do not require...

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18Mar

Provider Alert! Coronavirus disease 2019 (COVID-19) and Pregnancy

The following provider guidance is provided as a Texas Children’s Health Plan (TCHP) educational communication only. As many of our network providers are affiliated with other institutions and organizations who also set policy and procedure, this communication is not intended to replace, overwrite, amend or append to another institution’s guidance, policy or procedure. TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event. Attention: OB/GYN Providers Effective March 18, 2020 While...

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18Mar

Provider Alert! Reporting Provider Office Closures and Changes due to COVID-19

Attention: All Providers Effective March 17, 2020 Reporting Provider Office Closures and Changes due to COVID-19 The severity of the Coronavirus disease 2019 (COVID-19) may have affected your ability to operate during normal business hours. If your office has made any changes to the regular business operations or has closed entirely and unable to provide services to our members at this time, please complete an online questionnaire on our main website, https://www.texaschildrenshealthplan.org/for-providers. Be sure to include any changes to your office status and the...

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17Mar

March is National Nutrition Month

The Academy of Nutrition and Dietetics recognizes March as National Nutrition Month. This month we focus on healthy living through nutrition, bite by bite. Make informed food choices by creating and planning healthy meals, every day, each week. Start each day with a healthy breakfast. Drink more water. Hydration is important for both physical and mental functioning. Get physically active. Plan your meals and prep ahead. Learn and implement proper portion sizes. Substitute meat for plant-based alternatives. Get at least 8 hours of sleep per day. When eating...

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Provider Alert!
16Mar

Provider Alert! Health and Human Services (HHS) Promotes Women’s Health by Raising Awareness of Long-Acting Reversible Contraception (LARC)

Effective Date: March 5, 2020 The American College of Obstetricians and Gynecologists recommends LARCs for the following reasons: LARCs are the most effective reversible contraceptive method There is no further action required for the patient to avoid pregnancy after the device is in place LARCs have high rates of patient satisfaction and method continuation LARCs can be removed at any time if the patient plans to conceive or use another form of birth control How this impacts providers: Providers must decide if their patient qualifies as...

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Provider Alert!
02Mar

Provider Alert! Additional development screenings and autism screenings now allowable and payable beyond the standard screenings

Effective Date: June 3, 2020 Attention: Primary Care Providers Call to action: In addition to the required screenings, TCHP is allowing for a total of 12 developmental screenings up to age 6 during a Texas Health Steps Checkup within the following ages: 8.1-  2 screenings At ages 0-11 months 8.2- 3 screenings At age 12-23 months 8.3- 2 screenings At ages 12-23 months 8.4- 2 screenings At ages 24-35 months 8.5- 1 screening At 3 years of age 8.6- 1 screening At 5 years of age 8.7-1 screening At 6 years of age   If a developmental or...

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Provider Alert!
02Mar

Provider Alert! Prosthetics Codes Update

Effective Date: June 3, 2020 Attention: Prosthetics, DME providers, orthopedists, podiatrists, PCPs Call to action: Texas Children’s Health Plan will now configure the prosthetics procedures codes to require prior authorization according to the Texas Medicaid Provider Procedures Manual (TMPPM).  Currently, the only procedure codes on the prior authorization list are related to Breast Reconstruction. How this impacts providers: Provider offices should utilize the Standard Prior Authorization Form for prosthetics that require a prior authorization: https://www.texaschildrenshealthplan.org/for-providers/provider-resources/prior-authorization-information Next steps for providers: Providers should reference the prosthetic procedure...

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