Sec. 1369.453. APPLICABILITY TO CERTAIN MEDICATIONS. This subchapter applies with respect to only a medication that: (1) is covered by the enrollee's health benefit plan; (2) meets the prior authorization criteria specifically applicable to the medication under the health benefit plan on the date the request for synchronization is made; (3) is used for treatment and management of a chronic illness, as that term is defined by Section 1369.456 ; (4) may be prescribed with refills; (5) is a formulation that can be effectively dispensed in accordance with the medication synchronization plan described by Section 1369.456 ; and (6) is not, according to the schedules established by the commissioner of the Department of State Health Services under Chapter 481 , Health and Safety Code: (A) a Schedule II controlled substance; or (B) a Schedule III controlled substance containing hydrocodone.
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