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June 10: VDP Formulary, CAD, MCO Search Realignment Now Active

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A-2.4. Board Composition

The Board is composed of members appointed by the HHSC executive commissioner in accordance with Texas Government Code section 531.0736 and compliance with 42 CFR section 456.716 and Social Security Act section 1927(g)(3). All members are voting members.

This membership includes:

  1. At least 17 physicians and pharmacists providing services across the entire population of Medicaid recipients representing at least one of each of the following physician types:
    1. Provider of pediatrician services;
    2. Primary care physician;
    3. Provider of obstetrician and gynecologist services;
    4. Provider of child and adolescent psychiatry services; and
    5. Provider of adult psychiatry.
  2. Three representatives of Medicaid MCOs, all of whom must be physicians or pharmacists; and 
  3. One consumer advocate representing the Medicaid population.

Physician and pharmacist members must:

  1. Have experience in developing or practicing under a PDL;
  2. Have recognized knowledge and expertise in one or more of the following:
    1. Clinically appropriate prescribing of outpatient drugs;
    2. Clinically appropriate dispensing and monitoring of outpatient drugs;
    3. DUR, evaluation, and intervention; and
    4. Medical quality assurance; and
  3. Be licensed and in good standing with the Texas Medical Board or the Texas State Board of Pharmacy and actively provide services across the entire population of Medicaid in Texas.

Voting members with access to confidential drug pricing information will attend the executive session. MCO representatives (appointed under 4.B. above) will not have access to confidential drug pricing information and, therefore, will not attend the executive session. MCO representatives are able to vote and participate in all other discussions and action items before the Board, except as noted above.

Under Circular C-022: HHSC Policy for Advisory Committees and to the greatest extent possible, the HHSC executive commissioner appoints members who reflect the diversity of Texas.