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April 2022 Drug Utilization Review Board Meeting Summary
by CHRISTINA.FAULKNER on 05/05/2022
The Texas Drug Utilization Review Board met Friday, April 22, to make recommendations about clinical prior authorizations and drugs on the Texas Medicaid Preferred Drug List. To learn more, visit txvendordrug.com/about/news. |
March 2022 Specialty Drug List Available
by CHRISTINA.FAULKNER on 03/30/2022
The March 2022 biannual Specialty Drug List is now available. The SDL includes drugs MCOs may exclusively provide through their specialty pharmacy network. To learn more, visit txvendrodrug.com/about/news. |
Changes for Client Access to Mosquito Repellent Benefit Begin June 1
by TALESHIA.CORE on 02/24/2022
Beginning May 31, 2022, HHSC will stop using the Texas Medicaid Standing Order for Mosquito Repellent. Pharmacies must obtain a prescription from a Medicaid-enrolled prescribing provider to dispense mosquito repellent beginning June 1, 2022, for Medicaid, Children’s Health Insurance Program (CHIP), and Healthy Texas Women (HTW). HHSC has extended the effective date of the current standing order until May 31, 2022, to ensure providers have adequate notice regarding upcoming changes to the mosquito repellent benefit. To learn more, visit txvendordrug.com/about/news. |
Oxbryta Prior Authorization Criteria Updates Scheduled for April 5
by TALESHIA.CORE on 02/17/2022
On April 5, 2022, HHSC will revise the prior authorization criteria in the Sickle Cell Disease Agents clinical prior authorization for Oxbryta (voxelotor) to ensure alignment with the US Food and Drug Administration-approved indications and package inserts. The criteria update includes the FDA’s recent age expansion to 4 years and older, and the removal of criteria step 6 relating to the drug interaction with CYP3A4 inhibitors or fluconazole. The updated criteria guide document also includes pediatric dosing information tables. This clinical prior authorization remains optional for managed care. To learn more, visit txvendordrug.com/about/news. |
Cytokine and CAM Antagonists Criteria Updates Scheduled for April 5
by CHRISTINA.FAULKNER on 02/16/2022
On April 5, 2022, HHSC will make the following revisions to various medications within the Cytokine and CAM Antagonists clinical prior authorization criteria to ensure alignment with US Food and Drug Administration approved indications. This clinical prior authorization remains optional for managed care. To learn more, visit txvendordrug.com/about/news. |
Updates to Phosphate Binder Prior Authorization Criteria Scheduled for April 5
by CHRISTINA.FAULKNER on 02/16/2022
On April 5, 2022, HHSC will revise the phosphate binder non-preferred prior authorization criteria by transferring specific criteria to the phosphate binders clinical prior authorization. This update correlates with the recent Texas Drug Utilization Review Board-approved revisions to the phosphate binder clinical prior authorization criteria. In this process, HHSC will also rearrange some of the steps to help improve the way each step flows into the next. The changes to the non-preferred prior authorization criteria are mandatory for MCOs. The phosphate binders clinical prior authorization remains optional for managed care. To learn more, visit txvendordrug.com/about/news. |
Removal of Specialist Requirement from Clinical Prior Authorization Criteria Scheduled for January 3
by CHRISTINA.FAULKNER on 11/05/2021
On January 3, HHSC will remove the specialist requirement from the following clinical prior authorization criteria: CGRP Antagonist, Acute; CGRP Antagonists, Chronic; Emflaza; Ophthalmic Immunomodulators; Palforzia; Transthyretin Agents; VMAT2 Inhibitors; Wakix; Xyrem/Xywav; and Xelboraf. To learn more, refer to the Vendor Drug Program website at txvendordrug.com/about/news. |