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Cold and flu season Temporada de influenza y resfriados

ALERT: Stay healthy this cold and flu season! Learn more

ALERTA: ¡Mantente sano durante esta temporada de influenza y resfriados! Más información

New Website! ¡Nuevo sitio web!

ALERT: We have made the Texas Children’s Health Plan website even easier to use! Click here to learn more.

ALERTA: ¡Ahora el sitio web de Texas Children’s Health Plan es aún más sencillo de usar! Haz clic aquí para más información.

Enfamil shortage updates Escasez de Enfamil Reguline

ALERT: Shortage of Enfamil products until October 31, 2024. Learn more.

ALERTA: Escasez de productos de Enfamil hasta el 31 de octubre de 2024. Más información.

Change Healthcare Incident Change Healthcare incidente

Clinical Prior Authorization Updates for Enzymes

Date: May 20, 2021 Attention: Geneticists, Hematologists, and Oncologists Effective Date: June 30, 2021Call to action: Effective June 30, 2021, the Texas Health and Human Services Commission (HHSC) will update the enzymes prior authorization criteria to reflect recent FDA-approved administration changes. This impacts the following agents: Adagen (pegademase bovine), Ceprotin (protein C concentrate), Fabrazyme (agalsidase beta), and Revcovi (elapegademase). Adagen (J2504 procedure code) has been discontinued by the manufacturer.Ceprotin 400-600 units vial is no longer available through retail pharmacy benefits. The Ceprotin 400-600 units vial will only be available through the medical benefit (procedure code J2724).  The 1000 IU single-use vials will continue to be available through the pharmacy benefit. Clinical prior authorization updates for other enzymes:  
DrugProcedure CodeChanges effective June 30, 2021
Fabrazyme (agalsidase beta)J0180Updated age to > 2 years for confirmed Fabry’s disease
Revcovi (elapegademase)J3590Updated for diagnosis of adenosine deaminase severe combined immunodeficiency disease (ADA-SCID)
  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:
  1. https://txstarchip.navitus.com/pages/prior-authorization-forms.aspx
 If you have any questions, please email TCHP Pharmacy Department at: tchppharmacy@texaschildrens.org.For access to all provider alerts,log into: www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.