HHSC To Implement Clinical Prior Authorization on March 1, 2024

On March 1, 2024, HHSC will implement the Hormonal Therapy Agents clinical prior authorization (PDF).

This clinical prior authorization is required for fee-for-service and 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 are used for processing Medicaid fee-for-service claims. This chart is updated quarterly. Providers can use the MCO Search to find links to each MCO’s list of clinical prior authorizations.