Semi-annual Medicaid Preferred Drug List Update Coming July 25

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Texas Medicaid will perform the semi-annual update of the Medicaid preferred drug list on July 25. HHSC made the PDL changes based on recommendations made at the Jan. and April 2024 Texas Drug Utilization Review Board meetings. The following files are available:

  • April 26 preferred drug list recommendations
  • Jan. 26 preferred drug list decisions

As a reminder, 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 (4Ø8-D8). Refer to the Dispense as Written section of the Drug Policy chapter of the VDP Pharmacy Provider Procedure Manual for more information.

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.
  • The Preferred Drug List (PDF) will be posted by July 25 to reflect the recent changes.
  • The Preferred Drug List Criteria Guide (PDF) outlines the criteria used to evaluate the non-preferred prior authorization requests. It will be updated by July 25 to reflect the recent changes.