Manuals
Files
- Clinical Prior Authorization Assistance Chart (PDF)
- Drug Addition Process (PDF)
- Drug Use Criteria
- Drug Utilization Review Board - meeting documents
- Electronic Certificate of Information User Guide (PDF)
- Delivery Sign (PDF)
- Pharmacy Enrollment Chart (PDF)
- Pharmacy Assistance Chart (PDF)
- Prescriber Assistance Chart (PDF)
- Preferred Drug List
- Preferred Drug List Criteria Guide (PDF)
- Service Delivery Area Assistance Chart (PDF)
- Specialty drug process (PDF)
- Specialty drug submission spreadsheet (XLS)
- Texas Prior Authorization Call Center - Registration (PDF)
- Texas Prior Authorization Call Center - Provider Quick Reference (PDF)
Forms
- Refer to the list of enrollment forms.
- Refer to the list of claim processing forms.
- Refer to the list of drug-related forms.
- Refer to the list of Medicaid FFS Prior Authorization Requests (forms).
- Refer to the list of CSHCN Prior Authorization Requests (forms).
- Texas Medicaid Prior Authorization Reconsideration Request (HHS Form 1322)
Education Materials
| Name | Revised |
|---|---|
| Dispensing 72-hour Emergency Prescriptions (PDF) | 07/2019 |
| Pharmacy Resources for Managed Care (PDF) | 07/2019 |
| Real-time Eligibility Verification (PDF) | 07/2019 |
| Mosquito Repellent Benefit (PDF) | 07/2019 |
Data Files
- † Weekly file last updated July 26.
- ‡ Quarterly file last updated July 12.