Standard request form for prior authorization of prescription drug benefits advisory committee

Purpose: To advise the Commissioner on the technical, operational, and practical aspects of developing the single, standard prior authorization form required under Section 1369.304 for requesting prior authorization of prescription drug benefits.

Current committee members
Name	Member type	Employer
Kimberly Martin	Consumer	Epilepsy Foundation of Central & South Texas
Thomas Nguyen	Health Benefit Plan Issuer	Superior Health Plan
Vacant	Health Benefit Plan Networks of Providers	N/A
Dr. Shelagh Larson	Health Care Provider	Acclaim Physician Group
Dr. Lisa Ehrlich	Physician	L. Ehrlich & Associates Medical Clinic
Dr. Eddie Patton	Hospital	Methodist Sugar Land Hospital
Renee Baggett	Pharmacist	CHRISTUS Health
Alyssa Goree	Pharmacy Benefit Manager	Fairview Pharmacy Services
Dr. Heather Morel	Specialty Drug Distributor	McKesson Corporation
Dr. Chantelle Parker	Specialty Pharmacy	Walgreens Co. (Houston)
Aaliya Ahmad	HHSC Designee	Texas Health and Human Services Commission
Debra Diaz Lara	Commissioner Designee	Texas Department of Insurance

In accordance with Section 1369.305 of the Texas Insurance Code, the advisory committee shall be composed of commissioner of insurance or the commissioner's designee, the executive commissioner of the Health and Human Services Commission or the executive commissioner's designee and an equal number of members from the following groups of stakeholders:

physicians;
other prescribing health care providers;
consumers experienced with prior authorizations;
hospitals;
pharmacists;
specialty pharmacies;
pharmacy benefit managers;
specialty drug distributors;
health benefit plan issuers for the Texas Health Insurance Pool established under Chapter 1506;
health benefit plan issuers; and
health benefit plan networks of provider.

Want to serve on this committee? Visit our boards and committees webpage to learn more about our current openings and how to apply.