Cold and flu season Temporada de influenza y resfriados

ALERT: Stay healthy this cold and flu season! Learn more

ALERTA: ¡Mantente sano durante esta temporada de influenza y resfriados! Más información

New Website! ¡Nuevo sitio web!

ALERT: We have made the Texas Children’s Health Plan website even easier to use! Click here to learn more.

ALERTA: ¡Ahora el sitio web de Texas Children’s Health Plan es aún más sencillo de usar! Haz clic aquí para más información.

Enfamil shortage updates Escasez de Enfamil Reguline

ALERT: Shortage of Enfamil products until October 31, 2024. Learn more.

ALERTA: Escasez de productos de Enfamil hasta el 31 de octubre de 2024. Más información.

Change Healthcare Incident Change Healthcare incidente

Search

Removal of Specialist Requirements from CAD Clinical Policies and Prior Authorization Criteria

Date: July 13, 2022Attention: ProvidersEffective Date: August 1, 2022Providers 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: HHSC is updating the prior authorization criteria for some clinician administered drugs. How this impacts providers: HHSC will no longer require the prescription include consultation with or be written by a disease state specialist in the prior authorization policy and will remove this specialist requirement from the following CAD clinical policies and prior authorization criteria:
  • Antisense Oligonucleotide
  • Brexanolone
  • Burosumab-Twas
  • Crinzanizumab-Tmca
  • Emapalumab-Izsg
  • Esketamine
  • Ibalizumab-Uiyk
  • Inebilizumab-Cdon
  • Inotuzumab Ozogamicin
  • Luspatetcept-Aamt
  • Mogamulizumab-Kpkc
  • Moxetumomab Pasudotox-Tdfk
  • Tagraxofuso-Erzs
  • Teprotumumab-Trbw
Next steps for providers: Providers should adjust their prescribing patterns and share this communication with their staff If you have any questions, please email Provider Network Management at: providerrelations@texaschildrens.org.For access to all provider alerts,log into: www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.