Effective May 1, 2022, prior authorization is required when prescribing drugs for UnitedHealthcare Community Plan of Texas members to treat the following conditions:
The following drugs will require prior authorization:
| Drug | Clinical criteria name | Clinical criteria |
|---|---|---|
| EnspryngTM 120mg/mL prefilled syringe solution for injection | Cytokine and CAM antagonists |
|
| OpzeluraTM 1.5% topical cream | Topical immunomodulators |
|
| QULIPTATM 10mg tablet | Calcitonin gene-related peptide receptor (CGRP) antagonists, prophylaxis |
|
| QULIPTA 30mg tablet | ||
| QULIPTA 60mg tablet |
How to request prior authorization
You have several options to submit your prior authorization request:
Questions?
Contact your physician advocate or call Provider Services at 888-887-9003, 8 a.m.–6 p.m. CT, Monday–Friday.