OB/GYNs

Articles with relevant information for OB/GYNs

Provider Alert!

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...

Congenital Heart Defect Awareness Week

Sponsored by the American Heart Association, Congenital Heart Defect Awareness Week is observed every year from February 7-14. Congenital Heart Defect Awareness Week is an initiative created to promote awareness about congenital heart defects (CHDs). CHDs affect approximately 1% of births per year1. The most common type of birth defects, CHDs are present at birth and can affect the structure of a baby’s heart. Primary prevention of CHDs begin prior to conception. While we do not always understand what may cause...

American Heart Month

Heart disease is a catchall phrase for a variety of conditions that affect the heart’s structure and function1. This month we’re spotlighting American Heart Month in an effort to increase awareness about heart disease, as well as remind Texas Children’s Health Plan providers to encourage their patients to adopt healthy lifestyles. It’s important to inform your patients that heart disease can be prevented by incorporating healthy choices and managing health conditions. Share the following information with your patients as part of...

Provider Alert!

Provider Alert! URGENT – Makena (hydroxyprogesterone caproate) formulary change

Attention: OB providers Subject: URGENT - Makena (hydroxyprogesterone caproate) formulary change Effective Date: January 30, 2020   Call to action: The Texas Vendor Drug Program (VDP) will implement changes to the state Medicaid drug formulary, effective Thursday, January 30, 2020. Brand Makena formulations (intramuscular solution for injection, and subcutaneous auto-injectors) will remain on the preferred drug list (PDL). VDP has moved all generic hydroxyprogesterone caproate formulations to non-preferred drug status. Compounded formulations are not covered under the Medicaid formulary. Medicaid managed care plans are required...

Provider Alert! Novel Coronavirus Infection – 5 Confirmed US Cases

Attention: All providers Effective Date: January 27, 2020   TCHP wants to help keep you up-to-date on developing issues.  Because updates are coming so frequently about the new coronavirus, please look for our posts on TheCheckup.org where you’ll find the latest information.  Also check with your institutional leaders to see if they have developed specific protocols for infection control.  A new coronavirus (2019-nCoV) was recently detected in Wuhan City, China and is causing an outbreak of respiratory illness. The 2019-nCoV outbreak began in December...

Zantac/ranitidine drug recalls due to NDMA impurity

Multiple drug manufacturers have issued voluntary drug recalls for several Zantac drug products and its generic, ranitidine. Ranitidine is a histamine-2 receptor antagonist used to treat heartburn and related conditions. Potentially impacted customers are being notified with a recommendation to stop taking the medication and to discuss alternative therapies with their provider. The recalls are due to discovery of an impurity (N-nitrosodimethylamine [NDMA]) in the finished product. NDMA is classified as a probable human carcinogen that may be found in certain...

Provider Alert!

Provider Alert! Syphilis testing laws updated effective 9/1/2019

Texas law now mandates three syphilis tests for all pregnant women: at the first prenatal exam, during the third trimester (no earlier than 28 weeks gestation), and at delivery.  This new testing is required because congenital syphilis cases reported to the Texas Department of State Health Services (DSHS) more than doubled last year.  There were 367 cases of congenital syphilis in Texas in 2018, up from 164 in 2017. The increase in reported cases is likely due to a combination...

Inovalon

Understand your patients’ care gaps and improve your quality of care with the Inovalon HEDIS® Metrics Tool

Texas Children’s Health Plan PCPs and OB/GYN providers can now access data via the Inovalon HEDIS Metrics Tool through our Provider Portal. This new tool allows you to use performance and patient data so that you can independently manage your patient population, as well as improve the quality of disease management throughout your panel. Key features such as member-level gap reports and detailed HEDIS quality rates contribute to improving your provider incentive program rates. If you have any questions about Inovalon...

Provider Alert!

Provider Alert! DME/equipment/supplies exceeding Texas Medicaid Limitations

Effective October 1, 2019, Texas Children’s Health Plan will implement a prior authorization process for providers to request prior approval to provide DME/Equipment/Supplies to members 20 years of age and under in excess of benefit limitations. Texas Children’s Health Plan applies benefit limitations for DME/Equipment/Supplies in accordance with the Texas Medicaid Provider Procedure Manual (TMPPM) for all members eligible to receive the benefit, except for the following:   Next steps for providers: DME/Equipment/Supplies for a member who is 20 years of age or younger...

What does Service Coordination mean for your STAR Kids patients?

As a provider, you may have questions regarding the role Service Coordination plays in the lives of your STAR Kids patients. At Texas Children’s Health Plan, the goal of Service Coordination is to optimize health to ensure that the member’s tomorrow is better than his or her today. Service Coordination is a person-centered approach to care. Each of our members is assigned an appropriately licensed Service Coordinator. Our Service Coordinators are responsible for the following: Providing each member with initial and...