Office Managers

Articles with relevant information for Office Managers.

Provider Alert!
28May

Provider Alert! Housing Choice Plan Survey

Attention: All Providers Effective Date: Survey open May 15, 2020 until June 15, 2020 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 Health and Human Services Commission’s (HHSC) Behavioral Health Advisory Committee has approved the development of a Housing Choice Plan for individuals with...

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Provider Alert!
20May

Provider Alert! Reminder: Authorization Guidelines for a hospitalized member – post discharge services and supplies

Attention: All Providers Effective Date: May 20, 2020 Call to action: Texas Children’s Health Plan (TCHP) is aligned with the Uniform Managed Care Contract (UMCC) Guideline for members with an authorization request during hospitalization (reference: 8.1.8 Utilization Management). The guideline states that TCHP must issue coverage determinations for a member who is hospitalized at the time of the request, within one Business Day of receiving the request for services or equipment that will be necessary for the care of the Member immediately...

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11May

Provider Alert! Families First Coronavirus Response Act Information

Attention: Financial Management Services Agencies and Consumer Directed Services employers Effective Date: This rule is in effect April 2, 2020 to December 31, 2020. 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 United States Department of Labor (DOL) issued a temporary rule implementing...

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Provider Alert!
11May

Provider Alert! Live EVV Training Webinars in June

Attention: Existing Electronic Visit Verification (EVV) Users Effective Date: June 16-June 17 Call to action: In June, the Health and Human Services Commission (HHSC) and Texas Medicaid & Healthcare Partnership (TMHP) will hold live Electronic Visit Verification (EVV) policy and EVV Portal training webinars for program providers currently required to use EVV. How this impacts providers: Program providers must complete EVV Portal training and EVV policy training annually. See the following link for more information: https://hhs.texas.gov/sites/default/files/documents/doing-business-with-hhs/providers/long-term-care/evv/evv-required-training-checklist.pdf Next steps for providers: To meet the annual training requirement,...

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Provider Alert!
11May

Provider Alert! Cures Act EVV: Required EVV Training Webinars in May and June

Attention: Financial Management Services Agencies (FMSA) Effective Date: 6/2/2020 – 6/3/2020 Call to action: In May and June, the Health and Human Services Commission (HHSC) and Texas Medicaid & Healthcare Partnership (TMHP) will hold live Electronic Visit Verification (EVV) policy and EVV Portal training webinars for program providers and financial management service agencies (FMSAs) required to use EVV by the Cures Act. How this impacts providers: Program providers and FMSAs affected by the Cures Act EVV expansion must complete EVV Portal training and EVV policy...

By HHSC, OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, 0 CommentsRead more...
07May

Provider Alert! COVID-19 Medicaid Pharmacy Benefit Updated May 4, 2020

Attention: All Providers and Pharmacies Effective Date: May 4, 2020 The Texas Vendor Drug Program (VDP) has implemented several changes in response to COVID-19. This notice contains the latest updates, as well as links to the previously implemented changes. No-auto prior authorization (NAP) designation temporarily lifted: Normally, medications listed as NAP on the drug formulary by VDP require a manual hard stop in the system. Providers must call/fax to complete a prior authorization (PA) rather than allowing automated authorizations by reviewing historical pharmacy...

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Provider Alert!
21Apr

Provider Alert! VDP Formulary Updates – Update 3

Attention: All Providers and Pharmacies Effective Date: April 21, 2020 Call to action: VDP temporarily revised the preferred drug list to address reported possible drug shortages. A new claims processing edit has also been added to prevent overutilization of antimalarial drugs. Expanded NDCs: The non-preferred status of certain generic formulation NDCs were temporarily removed. The change allows pharmacies to dispense these drugs without requiring a non-preferred prior authorization, and provide continued access to necessary medication. The full list of NDCs can be found...

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Provider Alert!
21Apr

Provider Alert! Issues with EpiPen, Epi-Pen Jrs, and related generic products

Attention: All Providers and Pharmacies Effective Date: April 21, 2020 Call to action: The FDA is alerting stakeholders that EpiPen 0.3mg and EpiPen Jr 0.15mg auto-injectors, and authorized generic versions, may potentially have delayed or inappropriate injecting. Reasons for failure include: Device failure from spontaneous activation caused by using sideways force to remove the blue safety release Device failure from inadvertent or spontaneous activation due to a raised blue safety release Difficulty removing the device from carrier tube User error may also delay or prevent the...

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Provider Alert!
21Apr

Provider Alert! Synagis (palivizumab) removed from Texas Medicaid formulary

Attention: All Providers and Pharmacies Effective Date: April 14, 2020 Call to action: The 2019-2020 respiratory syncytial virus (RSV) season ended April 14 for all counties in Texas. Synagis (palivizumab) has been removed from the Texas Medicaid formulary as of April 14. How this impacts providers: Synagis is unproven for prophylaxis outside of the RSV season. Providers wishing to prescribe Synagis during this time must submit a medical necessity request. Next steps for providers: Providers should continue to follow American Academy of Pediatrics (AAP)...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, Uncategorized0 CommentsRead more...
17Apr

Provider Alert! Association for Community Affiliated Plans (ACAP) webinar on small business relief

Attention: All Providers Effective: April 15, 2020 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: TCHP would like to extend an invitation to our network providers to attend a webinar on COVID-19 small business relief on Tuesday, April 28, 2020 at 2:00PM CST. The Association...

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