Tex. Gov't Code § 549.0258 · Subchapter F. PRIOR AUTHORIZATION FOR CERTAIN DRUGS
PRIOR AUTHORIZATION AUTOMATION AND POINT-OF-SALE REQUIREMENTS.
Text — Current through the 89th 2nd Called Legislative Session, 2025
The executive commissioner, in the rules and standards governing the vendor drug program and as part of the requirements under a contract between the commission and a Medicaid managed care organization, shall:
(1) require, to the maximum extent possible based on a pharmacy benefit manager's claim system, automation of clinical prior authorization for each drug in the antipsychotic drug class; and
(2) ensure that, at the time a nonpreferred or clinical prior authorization edit is denied, a pharmacist is immediately provided a point-of-sale return message that:
(A) clearly specifies the contact and other information necessary for the pharmacist to submit a prior authorization request for the prescription; and
(B) instructs the pharmacist to dispense, only if clinically appropriate under federal or state law, a 72-hour supply of the prescription.
Notes and commentary — not statutory text
History
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.
Source of truth
- Edition
- Current through the 89th 2nd Called Legislative Session, 2025
- Official file
- https://statutes.capitol.texas.gov/Docs/GV/htm/GV.549.htm
- Text hash
- sha256 1edfb9d1fc58bb491a6ea464fc9c82be247011dad42f57af059b812a46cb2d98
- Composed by
- compose_tx.py 2026-10-05: the Legislative Council's chapter files read in document order; verify_tx.py's independent reading (lxml DOM walk) agrees character for character
Procedural information only. Not legal advice and not a substitute for the advice of an attorney. Confirm the current text with the official publisher before relying on it.