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Removal of Quantity Limits for Hepatitis C Medications, Including Mavyret Preferred Hepatitis C Treatment
by TALESHIA.CORE on 05/31/2023
On May 25, 2023, HHSC changed the quantity limit on direct-acting antiviral drugs for treating Hepatitis C. This change applies to all Medicaid clients in managed care and fee-for-service.
To learn more, visit txvendordrug.com/about/news. |
Clinical Prior Authorization Criteria for Calcitonin Gene-Related Peptide Receptor Antagonists Effective April 4
by CHRISTINA.FAULKNER on 03/23/2023
On April 4, 2023, HHSC will implement clinical prior authorization criteria for the treatment of calcitonin gene-related peptide receptor (CGRP) antagonists for Medicaid fee-for-service clients. The prior authorization criteria relate to Nurtec orally disintegrating tablets (ODT) and Ubrelvy, which are approved for treating acute migraines. This prior authorization is optional for MCOs. To learn more, visit txvendordrug.com/about/news.
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HHSC To Revise Livmarli Criteria On May 30
by CHRISTINA.FAULKNER on 04/07/2023
On May 30. 2023, HHSC will update the Livmarli criteria, part of the Cholestatic Pruritis prior authorization, to allow coverage for pediatric patients three months and older. Originally, Livmarli was approved for pediatric patients aged one and older. The Cholestatic Pruritis prior authorization is optional for MCOs.
To learn more, visit txvendordrug.com/about/news.
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Temporary Change in PDL Status for the Neuropathic Pain Drug Class Effective April 3
by CHRISTINA.FAULKNER on 04/07/2023
Effective April 3, 2023, the Texas Health and Human Services Commission (HHSC) has temporarily removed the non-preferred status from the generic product lidocaine 5% patch on the preferred drug list (PDL). (The lidocaine patch 5% is in the neuropathic pain drug class.) This temporary removal is in response to the shortage of the preferred brand name product Lidoderm 5% patch, which the manufacturer discontinued. Note: The preferred status of the brand name product Lidoderm (NDC 63481-0687-06) will not change so that any available existing stock can be used.
To learn more, visit txvendordrug.com/about/news. |
Hereditary Angioedema Agents Clinical Prior Authorization Effective for Medicaid Fee-for-Service on April 11
by CHRISTINA.FAULKNER on 03/30/2023
On April 11, 2023, HHSC will implement the Hereditary Angioedema (HAE) Agents (PDF) clinical prior authorization for clients who are enrolled in Medicaid fee-for-service. This clinical prior authorization is optional for Medicaid managed care organizations (MCOs). To learn more, visit txvendordrug.com/about/news.
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Enzymes Clinical Prior Authorization Effective for Medicaid Fee-for-Service on April 18
by CHRISTINA.FAULKNER on 03/30/2023
On April 18, 2023, HHSC will implement the enzymes clinical prior authorization for clients who are enrolled in Medicaid fee-for-service. This clinical prior authorization is optional for Medicaid managed care organizations (MCOs). To learn more, visit txvendordrug.com/about/news.
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Implementation of Inhaled Antibiotics Clinical Prior Authorization for Medicaid Fee-For-Service Set for May 2
by CHRISTINA.FAULKNER on 03/23/2023
On May 2, 2023, HHSC will implement the inhaled antibiotics clinical prior authorization for clients enrolled in Medicaid fee-for-service.
This prior authorization is optional for MCOs.
To learn more, visit txvendordrug.com/about/news.
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Revisions To Antimigraine Agents (Triptans) Clinical Prior Authorization Criteria Scheduled for April 4
by CHRISTINA.FAULKNER on 03/23/2023
On April 4, 2023, HHSC will revise the clinical prior authorization criteria for antimigraine agents (triptans). This revision will add a step to check for the maximum dose per 30 days of therapy as stated in the products' package inserts for established drug safety dosing.
This prior authorization is optional for MCOs.
To learn more, and see a list of affected drugs, visit txvendordrug.com/about/news.
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Revision of Olumiant Clinical Prior Authorization Criteria Scheduled for March 27
by CHRISTINA.FAULKNER on 03/23/2023
On March 27, 2023, HHSC will revise the clinical prior authorization criteria for Olumiant. Olumiant is a Janus kinase inhibitor approved and prescribed for adults with severe alopecia areata and moderate to severe active rheumatoid arthritis. These revisions are required to match the current prior authorization criteria with the information in the product package. The Olumiant criteria in the Cytokine and CAM Antagonists prior authorization clinical criteria guide is optional for MCOs.To learn more, visit txvendordrug.com/about/news. |
Respiratory Syncytial Virus (RSV) Season Ends on March 1
by TALESHIA.CORE on 02/15/2023
HHSC will close the RSV season’s Synagis prophylaxis therapy in all regions on March 1, 2023. HHSC based this decision on the Texas RSV task force and HHSC Office of the Medical Director recommendation because of the continued decrease in RSV test positivity below the threshold for two consecutive weeks. HHSC will continue to monitor RSV across the state and notify the public about any updates needed to access Synagis prophylaxis treatment.
To learn more, visit txvendordrug.com/about/news. |
Changes to Lovaza Clinical Prior Authorization Scheduled for March 21, 2023
by TALESHIA.CORE on 01/19/2023
On March 21, HHSC will make revise the Lovaza prior authorization criteria, including changing its name to Omega-3 Fatty Acids. A list of changes is available on the Vendor Drug Program website. This clinical prior authorization is optional for managed care organizations.
To learn more, visit txvendordrug.com/about/news. |