HHSC to Implement Gattex® Clinical Prior Authorization on June 6, 2023

Date: May 31, 2023

Attention: All Providers

Effective Date: June 6, 2023

Call to action: Texas Children’s Health Plan (TCHP) would like to let providers know that effective June 6, 2023, Texas Health and Human Services (HHSC) will be implementing the Gattex^® clinical prior authorization criteria, which was approved on April 28, 2023.

How this impacts providers: Starting June 6, 2023, TCHP will implement the Gattex^® clinical prior authorization criteria. The new criteria is available on the HHSC Vendor Drug Program website and can be viewed here: Gattex® Clinical Prior Authorization Updates.

Next steps for providers: Prescribers should share this communication with their staff. Providers must stay up-to-date on the latest restrictions and indications for these agents to ensure appropriate use to maximize patient outcomes. Provider must submit documentation (such as office chart notes, lab results, other pertinent clinical information, etc.) supporting that the member has met all appropriate criteria in support for medication approval.

If you have any questions, please email TCHP Pharmacy at: tchppharmacy@texaschildrens.org.

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