Injectable and Oral Desmopressin Clinical Prior Authorization Update

Date: January 26, 2021 Attention: PCPs, Endocrinologists, and Hematologists Effective Date: March 15, 2021Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated to the COVID-19 event.  TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event.Call to action: Effective March 15, 2021, Texas Medicaid will revise the injectable and oral desmopressin clinical prior authorizations to remove the denial criterion for hyponatremia. This is only applicable to medications dispensed by retail or specialty pharmacies through the pharmacy benefit. How this impacts providers: Currently, the desmopressin clinical prior authorization includes denial criterion if the member experienced a hyponatremia in the past 730 days. Texas Medicaid will remove the denial criterion to allow approval. Next steps for providers: Providers should share this communication with their staff. The updated prior authorization form is under “Resource” and will be effective March 15, 2021. Resource: Texas Prior Authorization Program Clinical CriteriaIf you have any questions, please email TCHP Pharmacy Department at: tchppharmacy@texaschildrens.org.For access to all provider alerts,log into: www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers