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TCHP Prior Authorization Requirement
Subject: TCHP Prior Authorization Requirement
Effective April 1, 2018, TCHP will be updating the prior authorization listing. This notice will serve as your 90-day advance notification of the change.
Please note there are some key changes for providers.
Removed from the list and will no longer require prior authorization:
- Walkers
- Vision Care, medically necessary
- High cost injectable drugs (>$75K per dose) in an outpatient level of care require prior authorization. Examples include: Kymriah, Spinraza, Exondys
- Progesterone therapy has been updated to Hydroxyprogesterone caproate injections.
- Transplant evaluation has been updated to transplants including solid organ and bone marrow.