SECTION 354.1853. Specialty Drugs

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(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.

Source Note: The provisions of this §354.1853 adopted to be effective May 9, 2012, 37 TexReg 3392

                    
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