ALERT: Stay healthy this cold and flu season! Learn more
ALERTA: ¡Mantente sano durante esta temporada de influenza y resfriados! Más información
Date: October 4, 2024
Attention: All Providers
Effective Date: October 1, 2024
Call to action: Texas Children’s Health Plan (TCHP) would like to let providers know that effective October 1, 2024, the Texas Health and Human Services (HHSC) will open all counties in State Health Service to Palivizumab (Synagis) prophylaxis for 2024-25 Fall/Winter Respiratory Syncytial Virus (RSV) season. Refer to the season schedule for each region's start and end dates.
How this impacts providers: HHSC will accept fee-for-service (FFS) prior authorization requests by fax and as early as September 23, 2024.
Prescribing providers must prescribe Synagis to infants meeting the criteria as described on the American Academy of Pediatrics website.
Drug Name | Strength | NDC |
Synagis | 100 MG/1 ml Vial | 66658023101 |
Synagis | 50 MG/0.5 ml Vial | 66658023001 |
Updated as of September 24, 2024. Refer to HHSC’s website for the most up-to-date information.
Providers can find their region using theinteraction region map (PDF)and selecting the buttons marked HHS regions and county names.
Table 1: Region Dates
Region | Start Date | End Date |
---|---|---|
1 - High Plains | Nov. 15, 2024 | April 14, 2025 |
2 - Northwest Texas | Nov. 15, 2024 | April 14, 2025 |
3 - Metroplex | Nov. 1, 2024 | March 31, 2025 |
4 - Upper East Texas | Nov. 1, 2024 | March 31, 2025 |
5 - Southeast Texas | Oct. 1, 2024 | Feb. 28, 2025 |
6 - Gulf Coast | Oct. 1, 2024 | Feb. 28, 2025 |
7 - Central Texas | Oct. 15, 2024 | March 14, 2025 |
8 - Upper South Texas | Nov. 1, 2024 | March 31, 2025 |
9 - West Texas | Nov. 15, 2024 | April 14, 2025 |
10 - Upper Rio Grande | Nov. 15, 2024 | April 14, 2025 |
11 - Lower South Texas | Oct. 15, 2024 | March 14, 2025 |
Additional Products for RSV:
The Food and Drug Administration (FDA) approved several new products for RSV prevention this year, including:
The Vendor Drug Program does not cover these products as a pharmacy benefit. Nirsevimab, intended for children, is available through TVFC. The other vaccines are available through the Medicaid medical benefit.
Next steps for providers: Refer to the 2024-2025 RSV season schedule for information regarding start and end dates for all regions. Providers should continue to follow American Academy of Pediatrics guidelines when prescribing and should share this communication with their staff.
Resources:
If you have any questions, please email Provider Relations at: providerrelations@texaschildrens.org.
For access to all provider alerts,log into:
www.texaschildrenshealthplan.org/providers/provider-news/provider-alerts.