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Changes to Lovaza Clinical Prior Authorization Scheduled for March 21, 2023

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On March 21, 2023, the Texas Health and Human Services Commission (HHSC) will update the criteria for Lovaza prior authorization as follows:

  • The title of the prior authorization criteria guide will change from Lovaza to Omega-3 Fatty Acids.
  • The criteria will change by adding manual steps to check for the severity of hypertriglyceridemia.
  • Lovaza will be approved for patients diagnosed with severe hypertriglyceridemia.
  • Vascepa will be approved for patients diagnosed with severe or elevated triglycerides.

The Omega-3 Fatty Acids (formerly Lovaza) clinical prior authorization is optional for managed care organizations (MCOs). The Pharmacy Clinical Prior Authorization Assistance Chart shows each MCO's prior authorizations and how those authorizations relate to those used for processing fee-for-service Medicaid claims. This chart is updated quarterly. Providers can also refer to MCO Resources for links to each MCO's list of clinical prior authorizations.

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