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D-3.5.1. Ends Day 90, as Needed

Based on the amount of a drug's estimated fiscal impact:

  1. PFD staff determine if the drug's coverage requires a notification or approval letter to LBB.
  2. VDP drafts the notification or approval letter using fiscal impact estimates determined by PFD.
  3. Actuarial Analysis staff review the drug's risk status and whether the drug will impact the managed care capitation rate. Staff will include this information as part of the notification or approval letter.
  4. PFD schedules the letter for review by HHSC Executive Leadership before sending it to LBB.