Texas: Medicaid prior authorization changes for 2022

Effective Jan. 1, 2022, you’re required to submit a prior authorization when prescribing drugs prescribed for UnitedHealthcare Community Plan of Texas members with the following conditions:

  • Cryopyrin-associated periodic syndromes (CAPS)
  • Deficiency of interleukin-1 receptor antagonist (DIRA)
  • Recurrent pericarditis (RP)
Drug Clinical criteria name Clinical criteria
Arcalyst 220 mg powder for injection Cytokine and CAM Antagonists Managed Care Clinical Prior Authorization

How to submit a prior authorization request

You have several options to submit your prior authorization request:

  1. EMR: Use PreCheck MyScript®
  2. UnitedHealthcare Provider Portal: Sign in, then go to Prior Authorizations, then select PreCheck MyScript
  3. CoverMyMeds®: Complete the online request
  4. Fax: Complete the Prescription Drug Benefits form and fax it to 866-940-7328

Please contact your physician advocate or call UnitedHealthcare Provider Services, toll-free, at 888-887-9003, 8 a.m.–6 p.m. CT, Monday–Friday.