UnitedHealthcareMedium ImpactPrior Auth
Texas Medicaid: New medication criteria and prior authorization updates
Published January 12, 2026Effective September 1, 2025
AI Summary
Texas Medicaid is implementing new prior authorization requirements for Yorvipath® and adding clinical criteria checks for Zoryve® for plaque psoriasis treatment. These changes affect UnitedHealthcare Community Plan of Texas CHIP, STAR, STAR Kids and STAR+PLUS plans.
Action Required
By September 1, 2025: Billing team must update prior authorization workflows to obtain approval before prescribing Yorvipath®. Update clinical documentation requirements for Zoryve® to include plaque psoriasis verification. Review linked prior authorization requirements and clinical criteria documents. Claims without proper authorization will be denied.
Plan Types
Medicaid
States
TX
Specialties
endocrinology, dermatology