Updated Pharmacy Clinical Prior Authorization Assistance Chart Now Available
AI Summary
A quarterly update to the Pharmacy Clinical Prior Authorization Assistance Chart is now available, showing which prior authorizations each Medicaid managed care organization (MCO) uses and how they relate to the Vendor Drug Program (VDP). The chart helps providers understand varying prior authorization requirements across different Medicaid MCOs.
Action Required
Immediately: Billing and pharmacy teams should review the updated Pharmacy Clinical Prior Authorization Assistance Chart to understand current prior authorization requirements for each Medicaid MCO. Use the MCO search tool on the VDP website to verify specific clinical prior authorization requirements for your Medicaid patients. Update internal pharmacy prior authorization workflows to reflect any changes in MCO requirements.
Plan Types
Medicaid
States
TX
Specialties
all-specialties