Tag - Zolgensma

Provider Alert!
29Nov

Provider Alert! Prior Authorization Criteria Update for Zolgensma Scheduled for February 1

Date: November 28, 2022 Attention: Providers Effective date: February 1, 2023 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 (TCHP) will update the prior authorization criteria for Zolgensma (J3399) effective February 1, 2023. TCHP will remove the Spinal Muscular Atrophy (SMA) type...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, 0 CommentsRead more...
Provider Alert!
26Sep

Provider Alert! Prior Authorization Criteria Update for Zolgensma

Date: September 20, 2022 Attention: All Providers Effective Date: November 11, 2022 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with 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 (TCHP) would like to inform providers that effective November 1, 2022, the Health and Human Services Commission (HHSC) will update the...

By Facilities, OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, 0 CommentsRead more...
Provider Alert!
01Apr

Provider Alert! Prior Authorization Criteria for Zolgensma Updated

Date: April 22, 2021 Attention: Neurologists and SMA specialists Effective Date: May 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: Prescribers should be aware of an update to prior authorization criteria for Zolgensma (onasemnogene abeparvovec) drug HCPCS code J3399.  Zolgensma is indicated for treatment of pediatric...

By Specialists, , , , , , 0 CommentsRead more...
Provider Alert!
24Nov

Provider Alert! Zolgensma Update – new TMPPM criteria pending publication

Attention: Neurologists and SMA specialists Effective Date: December 1, 2020  Call to action:  Prescribers should be aware of an update to prior authorization criteria for Zolgensma (onasemnogene abeparvovec) drug HCPCS code J3399. Zolgensma is indicated for treatment of pediatric patients (<2 years of age) with Spinal Muscular Atrophy (SMA). Effective December 1, diagnosis of Type I SMA (diagnosis code G120) will require three or less copies of SMN-2. Previous criteria required two or fewer copies. All other criteria will remain the same. How this impacts providers:...

By Provider Alert, Specialists, 0 CommentsRead more...
Provider Alert!
29Jul

Provider Alert! Vyondys-53 and Zolgensma updates

Attention: Neurologists Effective Date: July 1, 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: Vyondys-53 is a clinician-administered drug benefit of Texas Medicaid with the effective date of April 1, 2020, under the Healthcare Common Procedure Code (HCPCS) miscellaneous code J3490/C9399 and an...

By Primary Care Providers, Provider Alert, Specialists, 0 CommentsRead more...