TX HHS Form 1353. Texas Medicaid OxyContin Prior Authorization Request

The Texas Medicaid OxyContin Prior Authorization Request Form 1353 is a crucial document for healthcare providers to obtain prior authorization for prescription drug benefits. Issued by the Texas Health and Human Services (HHS), this form is designed for patients enrolled in Medicaid fee-for-service, ensuring timely access to necessary medication while maintaining quality patient care.

The form requires prescribers to provide detailed information about their patients, including diagnosis, nonprescription pain management therapies attempted, and prescribed strength of OxyContin. Additionally, prescribers must certify that the patient has a pain management agreement with them if the prescribed strength exceeds 40 mg. This comprehensive documentation ensures that prior authorization requests are thoroughly reviewed and processed efficiently.

The Texas Prior Authorization Call Center at 866-469-8590 is responsible for processing Form 1353, emphasizing the importance of completing both this form and the Texas Standard Prior Authorization Request Form (TDI Form) to avoid delays in patient care or denial. Healthcare providers must also specify whether an expedited or non-expedited review is required, depending on the patient's medical situation.