SNAP Update and ResourcesActualización y recursos de SNAP
On November 1, 2025, the requirements to receive and apply to the Supplemental Nutrition Assistance Program (SNAP) benefits have changed. To see the new policies to request SNAP benefits, click here and/or call 211 for SNAP assistance. Learn more
El 1 de noviembre de 2025, cambiaron los requisitos para recibir y aplicar para los beneficios del Programa de Asistencia Nutricional Suplementaria (SNAP, por sus siglas en inglés). Para consultar las nuevas políticas para aplicar para los beneficios de SNAP, haz clic aquí o llama al 211 para obtener ayuda de SNAP. Aprende Más
Transportation UpdateActualización de transporte
Starting December 15, 2025, SafeRide Health will become the new provider for all member rides to doctor appointments and pharmacy visits. After this date, Texas Children’s Health Plan will no longer use MTM for Non Emergency Medical Transportation (NEMT) services.
For other questions, please call Member Services at the number on the back of your member ID card.
A partir del 15 de diciembre de 2025, SafeRide Health será el nuevo proveedor para todos los viajes de los miembros a citas médicas y visitas a la farmacia. Después de esta fecha, Texas Children’s Health Plan ya no usará MTM para los servicios de Transporte Médico No Urgente (NEMT).
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:
