Duplicate Therapy Clinical Prior Authorization Criteria Revision Begins Oct. 19

Published on
August 24, 2021

On Oct 19, 2021, HHSC will remove the oral corticosteroids from the Duplicate Therapy clinical prior authorization criteria (PDF). This will allow for the approval of combination therapy with both oral and inhaled corticosteroids to treat asthma.

Duplicate Therapy clinical prior authorization is optional for MCOs. The Pharmacy Clinical Prior Authorization Assistance Chart (PDF) indicates which prior authorization each MCO uses. The chart is updated quarterly. Providers can also refer to the MCO Resources for links to each MCO's list of clinical prior authorizations.