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HHSC to Revise Qulipta Clinical Prior Authorization Criteria on June 27, 2023

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On June 27, 2023, the Texas Health and Human Services Commission (HHSC) will revise the clinical prior authorization criteria for atogepant (Qulipta), which is in the Calcitonin Gene-Related Peptide (CGRP) Receptor Antagonists (Prophylaxis) prior authorization. The revision allows for the drug to be used to prevent chronic migraines in adults.

The 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.

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