On June 6, 2023, HHSC will implement the Gattex clinical prior authorization (PDF). The Texas Drug Utilization Review Board approved this clinical prior authorization on April 28, 2023.
This clinical prior authorization is optional for managed care organizations (MCOs).
The Pharmacy Clinical Prior Authorization Assistance Chart shows each MCO's prior authorizations and how these authorizations relate to those that HHSC uses for processing fee-for-service Medicaid claims. This chart is updated quarterly. Providers can refer to the MCO Resources page for links to each MCO's list of clinical prior authorizations.