SafeRide Health (SRH) is the new provider for all NEMT rides to doctor appointments and pharmacy visits.
Depending on your needs, rides may include wheelchair-lift-equipped vehicles, stretcher vans, minivans, or ambulatory vans. Please let SRH know what type of ride you need when scheduling.
SafeRide Health (SRH) es el nuevo proveedor de todos los servicios de transporte médico que no son de emergencia (NEMT, por sus siglas en inglés) hacia consultas médicas y farmacias.
Según tus necesidades, los servicios de transporte pueden incluir vehículos con elevador para sillas de ruedas, camionetas con camilla, minivans o camionetas ambulatorias. Por favor, informa a SRH qué tipo de transporte necesitas al programar tu traslado.
Clinical Prior Authorization Updates for Cytokine and CAM Antagonist Agents
Date: March 25, 2021Attention: Gastroenterologists, RheumatologistsEffective Date: May 4, 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: Effective May 4, 2021, the Texas Health and Human Services Commission (HHSC) will update the cytokine and cell-adhesion molecule (CAM) antagonist agents prior authorization criteria to reflect recent FDA-approved administration changes. This impacts the following agents: Actemra (tocilizumab), Cimzia (certolizumab pegol), Humira (adalimumab), Ilaris (canakinumab), Kineret (anakinra), and Simponi Aria (golimumab).
Actemra IV infusion no longer available through retail pharmacy benefits
Actemra (tocilizumab 20 mg/mL) IV infusions will only be available through the medical benefit (procedure code J3262). Actemra ACTPen (auto-injector subcutaneous solution) and Actemra prefilled syringe subcutaneous solution will continue to be available through the pharmacy benefit.
Clinical prior authorization updates for other Cytokine CAM antagonists:
Drug
Changes effective May 4, 2021
Cimzia (certolizumab pegol)
A 30-day treatment trial of conventional therapy (e.g. mesalamine, sulfasalazine, corticosteroids, immunosuppressants) for Crohn’s disease must be tried in the last 6 months
Humira (adalimumab)
Updated age to > 5 years for Ulcerative Colitis
Ilaris (canakinumab)
Diagnosis of active Still’s disease added to approval criteria
Kineret (anakinra)
Diagnosis of deficiency of interleukin-1 receptor antagonist (DIRA) added to approval criteria
Simponi Aria (golimumab)
Diagnoses of polyarticular juvenile idiopathic arthritis (PJIA) and psoriatic arthritis (PsA) added to approval criteria for members > 2 years
Next steps for providers: Providers should share this communication with their staff. The updated prior authorization forms will be made available near the effective date on the Navitus website (see Resources link below).
Resources:
