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Update to “Texas Medicaid Guidance in Response to Abbott’s Voluntary Recall of Certain Powdered Formulas”

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Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to eligible clients. Administrative procedures such as prior authorization, precertification, referrals, and claims/encounter data filing may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the client's specific MCO for details.

This is an update to the article titled, “Texas Medicaid Guidance in Response to Abbott’s Voluntary Recall of Certain Powdered Formulas,” which was posted on this website on February 28, 2022.

Abbott Nutrition has added specific lots of Similac PM 60/40 powdered formula to the voluntary recall of Similac products. This is in addition to specific lots of Similac, Alimentum, EleCare, and EleCare Jr powder formulas that were voluntarily recalled on February 17, 2022. At this time, Similac PM 60/40 with lot code 27032K80 (can) / 27032K800 (case) are the only type and lots of this specialty formula being recalled.

 For existing prior authorizations of formulas affected by the recall, previously submitted documentation supporting medical necessity is sufficient to request the substitute formula. Suppliers should continue to work with ordering providers and clients to assist with adjustments and replacing recalled powdered formulas at no cost to the client. Any substitution should only be done under the recommendation and supervision of a healthcare professional.

 Human milk is considered a substitute for Similac 60/40. For information about coverage of donor human milk, see the Texas Medicaid Provider Procedures Manual, Durable Medical Equipment, Medical Supplies, and Nutritional Products Handbook, Section 2.2.13.

 For additional information for physicians and other healthcare providers, including guidance on how to identify recalled products and other alternatives to Similac, Similac PM 60/40, Alimentum, EleCare, and EleCare Jr formulas, see the following websites:

 FDA Investigation of Cronobacter and Salmonella Complaints: Powdered Infant Formula (February 2022) | FDA

 Abbott Recall | Similac, Alimentum, EleCare Powder Formulas (similacrecall.com)

 Health Partners | Texas WIC

 https://www.tmhp.com/resources/provider-manuals/tmppm

For more information, call the TMHP Contact Center at 800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 800-568-2413.