Tag - medicaid

Provider Alert!
18Mar

Provider Alert! Omnipod 5 Added to Medicaid and CHIP Formularies

Date: March 18, 2024 Attention: All Providers Effective date: February 22, 2024 Call to action: Texas Children’s Health Plan (TCHP) would like to let providers know that effective February 22, 2024, the Texas Health and Human Services (HHSC) allows coverage for Omnipod 5 through pharmacy benefit for both CHIP and Medicaid formularies. Members can obtain one (1) Omnipod 5 G6 intro kit per 365 days, and fifteen (15) units of Omnipod 5 C6 PODS per 30 days. HHSC is not requiring clinical prior...

By OB/GYNs, Office Managers, Pharmacy, Primary Care Providers, Provider Alert, Specialists, , , 0 CommentsRead more...
Provider Alert!
22Feb

Provider Alert! UPDATED Medicaid Re-enrollment Application Assistance is Available

Date: February 22, 2024 Attention: All Providers Call to action: Texas Children's Health Plan (TCHP) would like to remind providers that continued assistance is available to their patients who need help with their Medicaid Reenrollment Application. Providers should encourage patients with Texas Children’s Health Plan coverage to contact us for assistance and support. How can you help ensure your patients stay covered?  Your continued assistance is crucial to helping your patients maintain coverage so they can access health care. Please ask your patients to:  Make...

By OB/GYNs, Office Managers, Pharmacy, Primary Care Providers, Provider Alert, Specialists, , , 0 CommentsRead more...
Provider Alert!
13Feb

Provider Alert! 12-Month Postpartum Eligibility Extension for Medicaid and CHIP Pregnant Members

Date: February 13, 2024 Attention: Primary Care, Family Medicine, and Obstetric Care Providers Effective: March 1, 2024 Call to action: Texas Children’s Health Plan (TCHP) would like to share great news with providers about postpartum Medicaid coverage. The Texas Health and Human Services Commission (HHSC) extended postpartum Medicaid coverage from two to 12 months for eligible women, effective March 1, 2024, as part of House Bill 12 (H.B. 12), 88th Legislature, Regular Session, 2023. Also effective March 1, 2024, HHSC will be providing 12...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , 0 CommentsRead more...
Provider Alert!
08Nov

Provider Alert! COVID-19 Vaccine and Vaccine Administration Procedure Codes 91318, 91319, 91320, 91321, 91322, and 90480 Are Now Benefits of Medicaid and CHIP

Date: November 7, 2023 Attention: All Providers Effective for dates of service on or after September 11, 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that in accordance with the U.S. Food and Drug Administration’s amended Emergency Use Authorizations COVID-19 vaccine administration codes for the Pfizer-BioNTech and Moderna COVID-19 vaccines, vaccine procedure codes 91318, 91319, 91320, 91321, 91322, and vaccine administration procedure code 90480 are benefits for Medicaid and CHIP. How this impacts providers: The procedure codes are...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , , 0 CommentsRead more...
Provider Alert!
08Nov

Provider Alert! Vaccine Services Benefits Changes for Texas Medicaid

Date: November 6, 2023 Attention: All Providers Effective: October 1, 2023 Call to Action: Texas Children Health Plan (TCHP) would like to let providers know that effective for dates of service on or after October 1, 2023, vaccine services benefits have changed for Texas Medicaid.  On June 27, 2023, the Centers for Medicare & Medicaid Services (CMS) issued guidance on Section 11405 of the Inflation Reduction Act (IRA). Beginning October 1, 2023, statutory amendments made by Section 11405 of the IRA require Medicaid coverage...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , 0 CommentsRead more...
Provider Alert!
11Oct

Provider Alert! New Texas Medicaid & Healthcare Partnership (TMHP) Contracts

Date: October 10, 2023 Attention: All Providers Effective date: September 1, 2023 Call to action: The purpose of this communication is to inform providers that effective September 1, 2023 two new Texas Medicaid and Healthcare Partnership (TMHP) contracts went live: Accenture State Healthcare Services LLC (Accenture) is now the TMHP Business Operations and Business Integration (BusOps) vendor. The TMHP BusOps vendor acts as the project management office across the TMHP vendors and will manage the overall Medicaid ecosystem, including support services such as project management,...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , , , , , 0 CommentsRead more...
Provider Alert!
03Oct

Provider Alert! UPDATED Medicaid Re-enrollment Application Assistance is Available

Date: October 3, 2023 Attention: All Providers Call to action: Texas Children's Health Plan (TCHP) would like to remind providers that assistance is available to their patients who need help with their Medicaid Reenrollment Application. Providers should encourage patients with Texas Children’s Health Plan coverage to contact us for assistance and support. In-person application assistance at provider officesIn-office Application Assistance may be available to providers that are interested in supporting the reenrollment process for their patients, pending availability and office location. To...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , 0 CommentsRead more...
Provider Alert!
30Aug

Provider Alert! Radiology Benefit Updates for Texas Medicaid Effective September 1, 2023

Date: August 30, 2023 Attention: All Providers Effective Date: September 1, 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to let providers know that certain radiology benefit updates will be effective for Texas Medicaid for dates of service on or after September 1, 2023. Major changes include the following: The addition of benefit information for magnetic resonance elastography (MRE) New benefit for ultrasound transient elastography (TE) MRE (procedure code 76391) may be reimbursed for the diagnosis or monitoring of liver fibrosis or cirrhosis in...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , 0 CommentsRead more...
Provider Alert!
29Aug

Provider Alert! Medicaid Re-enrollment: Patients May Risk Losing Their Medicaid Plan!

Date: August 28, 2023 Attention: All Providers Call to action: Texas Children’s Health Plan (TCHP) would like to thank you for supporting your patients with maintaining coverage during the Medicaid re-enrollment currently underway. Background information: As you may know, Medicaid coverage rules have changed, and some Medicaid recipients 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...

By Facilities, OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , , 0 CommentsRead more...
Provider Alert!
28Aug

Provider Alert! HHSC to Add Skysona® as Medicaid and CHIP Benefit July 1, 2023, Prior Authorization Effective September 1, 2023

Date: August 24, 2023 Attention: All Providers Effective Date: September 1, 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to let providers know that effective September 1, 2023, the Texas Health and Human Services (HHSC) will be implementing required prior authorization criteria for Skysona® (procedure code J3590) for Medicaid and CHIP. Skysona® will become a benefit of Medicaid and CHIP on July 1, 2023. Skysona® (betibeglogene autotemcel) is indicated to slow the progression of neurologic dysfunction in boys 4-17 years...

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