2020-21 Respiratory Syncytial Virus Season Begins October 1, 2020

2020-21 Respiratory Syncytial Virus Season Begins October 1, 2020

The 2020-21 Respiratory Syncytial Virus (RSV) begins Oct. 1, 2020, for many counties in Texas. FirstCare will make the following changes this season to Synagis coverage and prior authorizations:

• FirstCare will not end-date NDCs for Synagis as in previous years and the drug will remain active on the formulary. Year-round access to Synagis on the formulary allows for consideration of off-season requests.
• Access to Synagis for children in CHIP is available as a pharmacy benefit effective Sept. 1. The Medicaid prior authorization criteria also apply to CHIP. Synagis is not available as a medical benefit for CHIP.
• FirstCare will remove the prior authorization criteria for the specialist or sub-specialist prescribing.

The schedule is staggered and is based on a patient's county of residence at the start of the RSV season. Refer to the Synagis season schedule for each region’s start and end dates. For additional information please click here. 

FirstCare Synagis Prior Authorization forms will be posted here on September 1, 2020.