Tag - pulmonology

Provider Alert!
08Dec

Provider Alert! Dupixent (dupilumab) Criteria Update

Date: December 7, 2021 Attention: Primary Care Providers and Pulmonologists Subject: Dupixent (dupilumab) Criteria Update Effective Date: October 20, 2021 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 October 20, 2021, Texas Medicaid revised criteria of the Dupixent (dupilumab).  Dupixent is FDA-approved as an add-on maintenance...

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Provider Alert!
13Jul

Provider Alert! Trikafta Age Expansion in Cystic Fibrosis Agents Clinical Prior Authorization Begins September 1

Date: July 8, 2021 Attention: Primary Care Providers and Pulmonologists Effective Date: September 1, 2021 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: Texas Children’s Health Plan will update the clinical prior authorization criteria for Trikafta (elexacaftor, tezacaftor, ivacaftor) to align with the FDA recent age...

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Provider Alert!
29Jun

Provider Alert! Nucala Clinical Prior Authorization Update

Date: June 29, 2021 Attention: Primary Care Providers and Pulmonologists Subject: Nucala Clinical Prior Authorization Update Effective Date: July 12, 2021 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 (HHSC) will update the clinical prior authorization criteria for Nucala in the...

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Provider Alert!
01Mar

Provider Alert! Clinical Prior Authorization Updates for Cystic Fibrosis Agents

Date: February 25, 2021 Attention: Pulmonologists Effective Date: April 6, 2021 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 April 6, 2021, the Texas Health and Human Services Commission (HHSC) will update the cystic fibrosis (CF) agents prior authorization criteria to reflect recent FDA-approved indication...

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Provider Alert!
07Jan

Provider Alert! New prior authorization requirements for Mepolizumab (Nucala)

Date: December 21, 2020 Attention: Allergists & Immunologists, Pulmonologists Effective Date:  February 1, 2021 Call to action: Texas Children’s Health Plan (TCHP) is aligning prior authorization criteria for mepolizumab (Nucala), J2182, with the Texas Medicaid Provider Procedures Manual (TMPPM). Mepolizumab (Nucala) is a clinician administered drug indicated for members with severe asthma with an eospinophilic phenotype.   Mepolizumab (Nucala) is also indicated as a steroid sparing agent for certain types of hypereosinophilic syndrome (HES) and eosinophilic granulomatosis with polyangiitis (EGPA). Below are the new prior...

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