Skip to main content
Labor Day Holiday Día del Trabajo

Texas Children's Health Plan will be closed on Monday, September 1st, in observance of Labor Day. In our absence, you can reach our after-hours nurse help line at 1-800-686-3831. We will resume normal business hours on Tuesday, September 2nd. Wishing you a safe and happy Labor Day!

Texas Children's Health Plan estará cerrado el lunes 1 de septiembre por el Día del Trabajo. Durante nuestra ausencia, puedes comunicarse con nuestra línea telefónica de ayuda fuera del horario habitual al 1-800-686-3831. Reanudaremos nuestro horario regular el martes 2 de septiembre. ¡Te deseamos un feliz y seguro Día del Trabajo!

New Rewards Coming Soon! ¡Se vienen nuevas recompensas!

Our Healthy Rewards Program is getting an update in September! For a sneak peek of all the changes - including new rewards and ways to redeem them - please click here.

¡Nuestro Programa Healthy Rewards tendrá su actualización en septiembre! Para ver un adelanto de todos los cambios, incluyendo nuevas recompensas y formas de canjearlas, haz clic aquí.

Uniform Opioid Policy Begins September 1

Attention: All Providers Effective Date: September 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: Effective September 1, 2020, the Vendor Drug Program (VDP) will implement a uniform opioid policy to encourage appropriate use and reduce opioid over-prescribing. The opioid policy does not apply to chronic pain, pain treatment as part of cancer care, hospice care, or other end-of-life or palliative care.  If diagnoses are not available in the medical data, exemptions will be handled on a case-by-case basis through the prior authorization process.  How this impacts providers: A provider may write an opioid prescription for up to 10 days without a refill.  Authorization will be required if the total daily dose of opioids exceeds 90 MME (morphine milligram equivalent) for members that no longer meet the definition of opioid naïve. A tapering plan may be established and approved on a case-by-case basis. If approved, the authorization is good for 6 months. Opioid naïve is defined as members who have taken opioids for a duration less than or equal to 7 days in the prior 60-day period. MME is an opioid dosage's equivalency to morphine, and is used to gauge opioid potential overdose risksNinety (90) MME per day for commonly prescribed opioids include: 
  • 90 mg of hydrocodone (9 tablets of hydrocodone/acetaminophen 10mg/325mg 
  • 60 mg of oxycodone (2 tablets of oxycodone sustained-release 30 mg) 
  • 20 mg of methadone (4 tablets of methadone 5 mg)
Next steps for providers: Complete details can be found at:  https://www.txvendordrug.com/about/news/2020/07/uniform-opioid-policy-begins-sept-1 and https://paxpress.txpa.hidinc.com/opcpdg.pdf 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.