HHSC Updates Clinical Prior Authorization Criteria Guides

Updated Clinical Prior Authorization Assistance Chart Now Available

An update to the Clinical Prior Authorization Assistance Chart is available. The chart is a quarterly update identifying the clinical prior authorizations each MCO uses and how those relate to those used for traditional Medicaid claim processing.

New Medicaid, CHIP Provisional Formulary Begins Nov. 18, 2024

Beginning Nov. 18, prescribers can write prescriptions for drugs added to the provisional formulary for people in Medicaid managed care, fee-for-service, and the Children’s Health Insurance Program.