HHSC to Revise Qulipta Criteria for Clinical Prior Authorization on June 27, 2023

May 19, 2023

On June 27, 2023, HHSC will revise the clinical prior authorization criteria for atogepant (Qulipta), part of the Calcitonin Gene-related Peptide (CGRP) Receptor Antagonists clinical  prior authorization (PDF). The revision allows for the drug to be used to prevent chronic migraines in adults.

The 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 are used 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.