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HHSC to Update Anxiolytics and Sedatives/Hypnotics Clinical Prior Authorization Criteria

Last updated on 5/19/2023

On June 22, 2023, the Texas Health and Human Services Commission (HHSC) will replace all instances of the phrase “history of drug abuse” with “history of drug abuse or dependence” in the clinical prior authorization criteria guide for anxiolytics and sedatives/hypnotics (ASHs).

This 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 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.

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