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Date: December 29, 2022
Attention: All Providers
Effective date: February 1, 2023
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, February 1,2023, the Texas Health and Human Services Commission (HHSC) will update the prior authorization criteria for Amvuttra (procedure code J0225).
Amvuttra (vutrisiran) is a transthyretin-directed small interfering RNA indicated for the treatment of the polyneuropathy of hereditary transthyretin-mediated (HATTR) amyloidosis in adults.
How this impacts providers: Members must meet the following criteria for approval for 12 months:
Initial Requests
Renewal or Continuation Therapy
Next steps for providers: Providers should share this communication with their staff. Refer to the Outpatient Drug Services Handbook Chapter of the Texas Medicaid Provider Procedure Manual (TMPPM) for more details on the clinical policy and prior authorization requirements.
If you have any questions, please email TCHP Pharmacy at: TCHPPharmacy@texaschildrens.org.
For access to all provider alerts,log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.