Jan. 2024 Preferred Drug List Published

The Jan. 2024 Medicaid Preferred Drug List is available. This update includes changes approved at the July and Oct. 2023 Drug Utilization Review Board meetings. The document includes formulary and prior authorization information, notations for drugs requiring clinical prior authorization, the review schedule, and appendices for cough and cold products, iron oral agents, and prenatal vitamins products.

• Jan. 25, 2024, Medicaid Preferred Drug List (PDF)
• Preferred Drug List Process
• Preferred Drug Documents
  • Preferred Drug List Criteria Guide (PDF)
  • Drug Class Review Schedules
  • Preferred Drug List Recommendations
  • Preferred Drug List Decisions
• Non-preferred Prior Authorization Information
• Obtaining prior authorization
  • Medicaid managed care
  • Traditional Medicaid
  • 72-hour emergency override instructions
• Texas Drug Utilization Review Board Documents

HHSC designates drugs on the Texas Medicaid formulary as preferred, non-preferred, or have neither designation. The preferred drug list includes only drugs identified as either preferred or non-preferred:

• Drugs not on the preferred list, or drugs identified on the list as "preferred", are available to people without prior authorization.
• Drugs on the list identified as "non-preferred" will require prior authorization.
• Some preferred and non-preferred drugs may require clinical prior authorization.

Drugs with preferred status drugs may include brand name medication which would not require a PDL prior authorization nor the value of "1" in the "Dispense as Written (DAW) Product Selection code" field (408-D8). Refer to the Dispense as Written section of the Drug Policy chapter of the Pharmacy Provider Procedure Manual for more information.

The PDL changes will appear in the Epocrates drug information system. Epocrates does not mirror the HHSC designations differentiated by dosage form. In these situations, Epocrates accompanies the designation with an explanatory message.