On March 21, 2023, HHSC will make the following revisions to the Lovaza prior authorization criteria:
- The title of the prior authorization criteria guide will change from Lovaza to Omega-3 Fatty Acids
- The criteria will change by adding manual steps to check for the severity of hypertriglyceridemia
- Lovaza will be approved for patients diagnosed with severe hypertriglyceridemia
- Vascepa will be approved for patients diagnosed with severe or elevated triglycerides
The Omega-3 Fatty Acids (formerly Lovaza) clinical prior authorization is optional for managed care organizations. The Pharmacy Clinical Prior Authorization Assistance Chart shows each MCO's prior authorizations and how those authorizations relate to those used for processing fee-for-service Medicaid claims. This chart is updated quarterly. Providers can also refer to the MCO Resources/node/53 for links to each MCO's list of clinical prior authorizations.