A lot of seasons start in the fall: Football, basketball, hockey, deer hunting, the holidays to name just a few.
How important any of those are to you depends on what you care about, of course.
But as a physician, you should be aware of another season that’s about to start (if you aren’t already): human respiratory syncytial virus season.
RSV season is not uniform in Texas. In fact, it starts earlier in some counties and remains active later in others.
As you probably know, RSV is a common respiratory virus that usually causes mild, cold-like symptoms, and most people recover in a week or two. But it can cause respiratory tract infections and serious lung disease in infants and children. It’s also a significant cause of respiratory illness in older adults.
Synagis (palivizumab) is available via prescription for high-risk patients, but it requires prior authorization.
Each private health plan has its own policy and requirements for prescribing Synagis. All plans require prior authorization but may differ on their buy-and-bill guidelines. The Texas Medical Association recommends using electronic prior authorization forms for better recordkeeping.
According to the Texas Health and Human Services Commission (HHSC), Synagis will be active on the Texas Medicaid and Children with Special Health Care Needs Services Program formularies beginning Sept. 17. It will be available for traditional Medicaid prior authorization that day as well.
Note that the option to purchase and bill through the Texas Medicaid & Healthcare Partnership will not be available, HHSC says.
More information, including the RSV schedule and Medicaid authorization forms, can be found on the HHSC website.
Last Updated On
September 12, 2018