Summary of July 2023 Drug Utilization Review Board Meeting Now Available

The Texas Drug Utilization Review Board met Friday, July 21, to make recommendations about clinical prior authorizations. The board did not review the preferred drug list at this meeting. Available online are:

  • A recording of this meeting’s webcast
  • A report of this quarter’s clinical prior authorization recommendations
  • Approved minutes from the Friday, April 28, meeting
  • The PDL drug class review schedule for the Thursday, October 12 meeting

Clinical Prior Authorization Updates

Clinical prior authorizations may implement for traditional Medicaid and Medicaid managed care at any time:

  • Providers and stakeholders will be notified once an implementation date has been set for traditional Medicaid.
  • Refer to MCO Resources for a link to each MCO’s list of active clinical prior authorizations.
  • The Pharmacy Clinical Prior Authorization Assistance Chart identifies which prior authorizations are utilized by each MCO and how those relate to those used by HHSC.


Approved as presented:

<p><strong>Approved with recommendations:</strong></p>

  • Fecal Microbiota Transplantation  (FMT) Agents (PDF)
    • Vowst – new criteria
      • Changed check for antibiotic treatment to ‘1 claim for antibiotic treatment for CDI’
      • Added the following information: To provide information about inpatient antibiotic treatment for FFS clients, prescribers may call the FFS PA call center at 877-728-3927. For MCO clients, prescribers can access MCO PA call center information at:
      • Removed metronidazole from Table 3, antibiotics for the treatment of CDI
  • Opioid/Benzodiazepine/Muscle Relaxants Combinations (PDF)
    • Added a check for seizure disorder in criteria where benzodiazepines are included
  • Veozah (fezolinetant) (PDF)
    • New Criteria
      • Added a check for hepatic function tests

Preferred Drug List Reminders

The following are reminders for the preferred drug list (PDL):

  • The board made no PDL recommendations at this meeting. The two-day Oct. DUR board meeting will review the the July and Oct. scheduled PDL classes. HHSC will incorporate the approved decisions from the Oct. meetings into the PDL published in Jan. 2024.
  • Prescribing providers must use the Medicaid formulary and preferred drug list.
  • MCOs should adhere to the Medicaid formulary and preferred drug list. Providers should evaluate a drug’s formulary status before its preferred status.

About the Texas DUR Board

Board members meet quarterly in Austin to make recommendations about outpatient prescription drugs in the Medicaid program. The schedule of upcoming meetings, instructions on how to submit written materials to the board, and directions about publicly testifying before the board are available on the VDP website.