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.
February 27, 2020
Members Sought for the Drug Utilization Review Board
February 26, 2020
Revised Growth Hormone Clinical Prior Authorization Begins May 28
February 7, 2020
January 2020 Drug Utilization Review Board Meeting Summary
February 5, 2020
January 2020 Preferred Drug List Recommendations Now Available
February 4, 2020
Clinical Prior Authorization Assistance Chart Now Available
January 27, 2020
Jan. 2020 Preferred Drug List Published