April 12, 2017

HHS will implement the Nuedexta clinical prior authorization (PDF) for individuals enrolled in traditional Medicaid on May 2, 2017. This prior authorization was approved by the Texas Drug Utilization Review Board on January 27, 2017.

This prior authorization is optional for Medicaid managed care. The Pharmacy Clinical Prior Authorization Assistance Chart (PDF) shows the criteria each MCO uses and how those criteria relate to those used for traditional Medicaid claim processing.  This chart is updated quarterly. Providers can also refer to the MCO Resources for links to each MCO's clinical prior authorizations.