Texas § 549.0258 PRIOR AUTHORIZATION AUTOMATION AND POINT-OF-SALE REQUIREMENTS.

Texas Statutes

§ 549.0258 — PRIOR AUTHORIZATION AUTOMATION AND POINT-OF-SALE REQUIREMENTS.

Texas § 549.0258

Code GVGovernment Code

This text of Texas § 549.0258 (PRIOR AUTHORIZATION AUTOMATION AND POINT-OF-SALE REQUIREMENTS.) is published on Counsel Stack Legal Research, covering Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Tex. Government Code Code Ann. § 549.0258 (2026).

Text

Sec. 549.0258. PRIOR AUTHORIZATION AUTOMATION AND POINT-OF-SALE REQUIREMENTS. The executive commissioner, in the rules and standards governing the vendor drug program and as part of the requirements under a contract between the commission and a Medicaid managed care organization, shall:

(1)require, to the maximum extent possible based on a pharmacy benefit manager's claim system, automation of clinical prior authorization for each drug in the antipsychotic drug class; and

(2)ensure that, at the time a nonpreferred or clinical prior authorization edit is denied, a pharmacist is immediately provided a point-of-sale return message that:

(A)clearly specifies the contact and other information necessary for the pharmacist to submit a prior authorization request for the prescription; and

(B)i

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Sec. 549.0258. PRIOR AUTHORIZATION AUTOMATION AND POINT-OF-SALE REQUIREMENTS. The executive commissioner, in the rules and standards governing the vendor drug program and as part of the requirements under a contract between the commission and a Medicaid managed care organization, shall:
(1) require, to the maximum extent possible based on a pharmacy benefit manager's claim system, automation of clinical prior authorization for each drug in the antipsychotic drug class; and
(2) ensure that, at the time a nonpreferred or clinical prior authorization edit is denied, a pharmacist is immediately provided a point-of-sale return message that:
(A) clearly specifies the contact and other information necessary for the pharmacist to submit a prior authorization request for the prescription; and
(B) instructs the pharmacist to dispense, only if clinically appropriate under federal or state law, a 72-hour supply of the prescription.