72-hour emergency overrides apply to non-preferred drugs on the preferred drug list or drugs subject to clinical prior authorization. Pharmacies will be paid in full for 72-hour emergency prescription claims.
To learn what is required to submit a 72-hour emergency claims, pharmacy staff should refer to the Pharmacy Provider Procedure Manual. A 72-hour emergency prescription claim can be used for people enrolled in either traditional Medicaid or Medicaid managed care:
- Authorization for Traditional Medicaid claims should be directed to the Texas Prior Authorization Call Center.
- Pharmacies submitting claims for people enrolled in Medicaid managed care should refer the prescribing provider to the person's MCO's prior authorization call center.
We encourage pharmacy staff to review and share the Dispensing 72-hour Emergency Prescriptions instructions and reproduce for staff education.
November 18, 2019
October 2019 Drug Utilization Review Board Meeting Summary
November 8, 2019
Clinical Prior Authorization Assistance Chart Now Available
November 6, 2019
October 2019 Preferred Drug List Recommendations Now Available
November 4, 2019
2020 Drug Utilization Review Board Schedule Available
October 30, 2019
New Indication for Dupixent Clinical Prior Authorization
October 23, 2019
Anticonvulsant Therapeutic Class Update for Oct. DUR Board Meeting