Flu Season Alert!Alerta de temporada de influenza:
Don’t let germs win this season – protect yourself and your family!
The flu vaccine is your best defense against flu and related complications – PLUS, it is a covered benefit for Texas Children’s Health Plan members! Learn more!
¡No permitas que los gérmenes ganen esta temporada! ¡Protégete a ti y a tu familia!
La vacuna contra la influenza es tu mejor defensa contra la influenza y sus complicaciones. Además, ¡es un beneficio cubierto para los miembros de Texas Children's Health Plan! Aprende más
Updated Pharmacy Clinical Prior Authorization Assistance Chart Now Available
Date: June 24, 2025
Attention: All Providers
Call to action: The purpose of this communication is to inform providers the quarterly update to the Pharmacy Clinical Prior Authorization Assistance Chart is now available. This chart shows which prior authorizations each managed care organization (MCO) uses and how these prior authorizations relate to those that the Vendor Drug Program (VDP) uses.
All Medicaid MCOs must perform specific clinical prior authorizations. These authorizations may differ between MCOs, and each MCO chooses which ones to use. The published criteria guide explains the steps that Medicaid follows to review authorization requests. These steps also apply to traditional Medicaid claims that are processed by the VDP.
Next step for providers: For more information about each MCO’s clinical prior authorization requirements, use the MCO search tool, and follow the search instructions on the VDP website. The search results include each MCO’s clinical prior authorization website and call center phone number.
