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Update to TMPPM Clinician-Administered Drugs Handbook

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Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to eligible clients. Administrative procedures such as prior authorization, pre-certification, referrals, and claims/encounter data filing may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should contact the client's specific MCO for details.

Beginning October 1, 2018, TMHP will update the Texas Medicaid Provider Procedures Manual, Clinician-Administered Drugs Handbook to include benefit criteria and prior authorization requirements in Section 28, “Inotuzumab ozogamicin (Besponsa).”

For more information, call the TMHP Contact Center at 800-925-9126.