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Implementation of Inhaled Antibiotics Clinical Prior Authorization for Medicaid Fee-for-Service Set for May 2, 2023

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On May 2, 2023, the Texas Health and Human Services Commission (HHSC) will implement clinical prior authorization for inhaled antibiotics for clients who are enrolled in Medicaid fee-for-service.

This prior authorization is optional for Medicaid managed care organizations (MCOs). 

The Pharmacy Clinical Prior Authorization Assistance Chart shows each MCO's prior authorizations and how these authorizations relate to those that are used for processing fee-for-service Medicaid claims. This chart is updated quarterly. Providers can refer to the MCO Resources page for links to each MCO’s list of clinical prior authorizations.

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