Texas Administrative Code
Title 1 - ADMINISTRATION
Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION
Chapter 354 - MEDICAID HEALTH SERVICES
Subchapter F - PHARMACY SERVICES
Division 3 - MEDICATIONS
Section 354.1853 - Specialty Drugs
Universal Citation: 1 TX Admin Code ยง 354.1853
Current through Reg. 49, No. 38; September 20, 2024
(a) The Health and Human Services Commissions (HHSC) will develop, maintain, and publish a list of specialty drugs on the Texas Medicaid Vendor Drug Program website.
(b) HHSC will include a drug on the specialty drug list if HHSC determines that the drug meets all of the following criteria:
(1) The drug is used to treat and is
prescribed for a person with a complex, chronic, or rare medical condition that
is progressive, can be debilitating or fatal if left untreated or undertreated,
or for which there is no known cure. Examples of such conditions include
multiple sclerosis, cystic fibrosis, hemophilia, and rheumatoid
arthritis.
(2) The drug is not
routinely stocked at a majority of community retail pharmacies.
(3) The drug has special handling, storage,
inventory, or distribution requirements.
(4) Patients receiving the drug require
complex education and treatment maintenance, such as complex dosing, intensive
monitoring, or clinical oversight.
Disclaimer: These regulations may not be the most recent version. Texas may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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