Preferred Drug List Program

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The Texas Vendor Drug Program announces the implementation of a Medicaid Preferred Drug List (PDL). Under the Preferred Drug List, all drugs currently available to Medicaid recipients will continue to be available. Preferred drugs will be available without prior authorization, while non-preferred drugs will require prior authorization, which may involve the prescriber or one of their staff representatives calling the Texas Prior Authorization Call Center to obtain approval before the drug can be dispensed.

In some cases, HHSC will already have claims data that indicates that the patient has met the prior authorization criteria for the non-preferred drug requested. In those cases, the prescription will be prior authorized without the necessity of a phone call. In other cases, the prescriber or one of their staff representatives will have to call the Texas Prior Authorization Call Center to obtain approval before the drug can be dispensed. Approved requests for prior authorization will be valid for one year.

In cases where a non-preferred drug is deemed medically necessary the Texas Vendor Drug Program will allow for a 72-hour emergency supply of the non-preferred drug. The request should be submitted to the call center where it will be processed on the next business day.

The Texas Medicaid Preferred Drug List is now available on the Epocrates drug information system. The service is free and provides instant access to information on the drugs covered by the Texas formulary on a Palm or Pocket PC handheld device. To register for the service, go to the Epocrates website and sign up for Epocrates Rx.

PT Home | TX Medicaid Home |TX Medicaid Drug Utilization Review Board

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