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, 2021Providers 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 expansion and guidance from the Texas Health and Human Services (HHSC). Effective September 1, 20201, patients aged 6 through 11 years of age with at least one copy of the F508del mutation, or specific mutations in the CFTR gene, will be eligible to receive Trikafta. How this impacts providers: Providers will need to use updated prior authorization forms that will be made available before September 1, 2021. Providers should share this update with their staff as well. Resources:

1. Navitus TX Medicaid Prior Authorization Forms

If you have any questions, please email Provider Network Management at: TCHPPharmacy@texaschildrens.org.For access to all provider alerts,log into: www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers