Change to Thiazolidinediones Clinical Prior Authorization Begins February 4, 2021

Change to Thiazolidinediones Clinical Prior Authorization Begins February 4, 2021

FirstCare follows the Texas VDP formulary. Beginning February 4, 2021, Texas Medicaid will no longer subject Oseni, a combination of Thiazolidinediones (TZD) and Dipeptidyl Peptidase-4 (DPP-4) inhibitor drug, to the TZD clinical prior authorization criteria (PDF)(link is external). Oseni is not recommended for patients with severe renal impairment or end-stage renal disease requiring dialysis. Therefore, the TZD criteria are deemed inappropriate for this drug. Oseni will continue to be subject to the DPP-4 Inhibitors clinical prior authorization criteria (PDF)(link is external). 

This prior authorization is optional for use in Medicaid managed care. The Pharmacy Clinical Prior Authorization Assistance Chart (PDF) shows the prior authorization each MCO uses and how those authorizations relate to the authorizations used for traditional Medicaid claim processing. This chart is updated quarterly. Providers can also refer to the MCO Resources for links to each MCO's list of clinical prior authorizations.

For additional information click here.

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