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Revision of Olumiant Clinical Prior Authorization Criteria Scheduled for March 27, 2023

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On March 27, 2023, the Texas Health and Human Services Commission (HHSC) will revise the clinical prior authorization criteria for Olumiant. Olumiant is a Janus kinase inhibitor approved and prescribed for adults with severe alopecia areata and moderate to severe active rheumatoid arthritis. These revisions are required to match the current prior authorization criteria with the information in the product package.

The Olumiant criteria in the Cytokine and CAM Antagonists prior authorization clinical criteria guide are optional for managed care organizations (MCOs).

The Pharmacy Clinical Prior Authorization Assistance Chart shows each MCO's prior authorizations and how these authorizations relate to those used for processing fee-for-service Medicaid claims. This chart is updated quarterly.

Providers can also refer to the MCO Resources for links to each MCO's list of clinical prior authorizations.

Email vdp-formulary@hhsc.state.tx.us with comments or questions.