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STAR Kids Prior Authorization Forms

  • Acthar
  • Agents for Gaucher's Disease
  • Alinia
  • Aliskiren-containing Agents
  • Allergen extracts
  • Altbax
  • Amitiza
  • Androgenic Agents
  • Antiemetics
  • Anti-Influenza Agents
  • Binge Eating Disorder
  • CGRP Antagonists
  • Cablivi
  • Carisoprodol
  • Chloroquine/Hydroxychloroquine
  • CNS Stimulants
  • Colchicine Agents
  • Colcrys
  • Compound Medications
  • Cytokine and CAM Antagonists
  • DPP-4 Inhibitors
  • Dispensing Limit Override
  • Dupixent
  • Elidel/Protopic (Topical Immunomodulators)
  • Emflaza
  • Enzymes
  • Erythropoiesis-Stimulating Agents
  • Flexeril/amrix
  • General Prior Authorization
  • GI Motility Agents
  • GLP-1 Receptor Agonists
  • Glucose Agents
  • Growth Hormone
  • Hepatitis C
  • Hereditary Angioedema
  • Imiquimod
  • Increlex
  • Injectable PAH
  • Kalydeco Orkambi Symdeko
  • Lidoderm Patches
  • Lovaza Vascepa
  • Makena
  • Migraine Agents
  • Morphine Equivalent Dose Override
  • Non-Preferred Glucose Test Strips Disks Meters
  • Opioid Benzodiazepine Pain Therapy
  • Opioid Policy
  • Oxycodone ER
  • PDE5-Inhibitors
  • Proprotein Convertase Subtilisin Kexin Type 9 (PCSK9) Inhibitors
  • Propylthiouracil
  • Pulmonary Hypertension Agents
  • Ranexa
  • Sickle Cell
  • Sildenafil Tadalafil
  • Synagis
  • Suboxone
  • Symlin
  • Trikafta
  • Triptan Dihydroergotamine Agents
  • VMAT2 Inhibitors
  • Xifaxan
  • Zelboraf
 
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  • Home
  • Network Participation
    • Network Participation
    • Attestation and Agreement
    • Credentialing and Recredentialing
    • Provider and Pharmacy Directories
  • Claims & Eligibility
    • Claims
    • Eligibility
    • Utilization Management (Prior Authorizations)
    • Long Term Services and Support (LTSS)
    • Provider Administered Drugs
    • Referral Requirements
    • STAR Kids Referral and Authorization Process
    • Electronic & Paper Submission Edits
  • Education & Reference
    • Education and Reference
    • Blue Review
    • Education Materials
    • Electronic Visit Verification (EVV)
    • Forms
    • News
    • Provider Training
    • Texas Health Steps (THSteps) Toolkit
    • Value-Added Services for STAR, CHIP and STAR Kids
    • Medicaid Provider Information on COVID-19 Coverage
  • Clinical Resources
    • Clinical Resources
    • Behavioral Health
    • Clinical Practice Forms
    • Early Childhood Intervention
    • Medical Policies
    • Vision
    • eviCore Prior Authorization Program
    • Quality Improvements (QI) Toolkits and Tip Sheets
  • Pharmacy
    • Pharmacy
    • Home Delivery Pharmacy (Mail-Order Pharmacy)
    • Benefits and Claims
    • Pharmacy Clinical Edits
    • Preferred Drug List
    • Medicaid (STAR) and CHIP Prior Authorization Forms
    • STAR Kids Prior Authorization Forms