Pharmacy Benefit
Makena (hydroxyprogesterone caproate injection) requires clinical prior authorization for traditional Medicaid clients. Providers should complete the Makena Criteria and Prior Authorization Request Form (PDF). Makena requests are handled by the Texas Prior Authorization Call Center. Medicaid MCOs may elect to require the same clinical prior authorization for Makena. Pharmcy staff should consult with the MCO for its specific requirements and process.
Medical Benefit
Makena and the compounded version of 17P will continue to be available as a Medicaid medical benefit. For additional information about the medical benefit, please visit TMHP or call the TMHP Contact Center at 1-800-925-9126.