Changes to Lovaza Clinical Prior Authorization Scheduled for March 21, 2023

Date: February 15, 2023

Attention: Providers

Effective Date: March 21, 2023

Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated to the COVID-19 event.  TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event.

Call to action: The Texas Health and Human Services (HHS) will revise the Lovaza clinical prior authorization criteria guide to include any covered omega-3 fatty acids drugs.

How this impacts providers:

●      The title of the prior authorization criteria guide will change from Lovaza to Omega-3 Fatty Acids. 

●      The criteria will change by adding manual steps to check for the severity of hypertriglyceridemia. 

●      Lovaza will be approved for patients diagnosed with severe hypertriglyceridemia

●      Vascepa will be approved for patients diagnosed with severe or elevated triglycerides.

Updated Omega-3 fatty acids prior authorization form can be found here.

For access to all prior authorization forms and formulary, visit: https://txstarchip.navitus.com/ and click “Prior Authorizations”

If you have any questions, please email TCHPPharmacy at: TCHPPharmacy@texaschildrens.org

For access to all provider alerts,log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.