Texas Prior Authorization of Prescription Drugs

State:
Texas
Control #:
TX-NOFR002
Format:
PDF
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Description

Prior Authorization of Prescription Drugs Texas Prior Authorization of Prescription Drugs is a program that requires certain medications to be pre-approved before they can be prescribed to a patient in Texas. The program is administered by the Texas Health and Human Services Commission (HHSC) and applies to both Medicaid and the Children’s Health Insurance Program (CHIP). To be approved for prior authorization, the patient must meet certain criteria, and the medication must be deemed medically necessary. Types of Texas Prior Authorization of Prescription Drugs include: • Non-preferred drugs: These are drugs that are generally more expensive than the preferred drugs listed in the Texas Drug Formulary. • Brand-name drugs: These are drugs that are only available as brand-name drugs and require prior authorization. • Step therapy drugs: These are drugs that require the patient to have tried other, less expensive drugs before the more expensive medication can be prescribed. • Multi-source drugs: These are drugs that are available from multiple sources and require prior authorization. • New use drugs: These are drugs that are being prescribed for a new medical condition and require prior authorization.

Texas Prior Authorization of Prescription Drugs is a program that requires certain medications to be pre-approved before they can be prescribed to a patient in Texas. The program is administered by the Texas Health and Human Services Commission (HHSC) and applies to both Medicaid and the Children’s Health Insurance Program (CHIP). To be approved for prior authorization, the patient must meet certain criteria, and the medication must be deemed medically necessary. Types of Texas Prior Authorization of Prescription Drugs include: • Non-preferred drugs: These are drugs that are generally more expensive than the preferred drugs listed in the Texas Drug Formulary. • Brand-name drugs: These are drugs that are only available as brand-name drugs and require prior authorization. • Step therapy drugs: These are drugs that require the patient to have tried other, less expensive drugs before the more expensive medication can be prescribed. • Multi-source drugs: These are drugs that are available from multiple sources and require prior authorization. • New use drugs: These are drugs that are being prescribed for a new medical condition and require prior authorization.

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Texas Prior Authorization of Prescription Drugs