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Temporary Non-Preferred Status Assigned to New Medicaid Drugs Starting September 1, 2025

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On September 1, 2025, the Vendor Drug Program (VDP) will begin assigning temporary non-preferred (TNP) status to certain drugs on the Medicaid formulary.

House Bill (H.B.) 3286, 88th Legislature, amended Section 531.072 of the Texas Government Code to grant TNP status to newly available drugs that have not yet been reviewed by the Texas Drug Utilization Review Board. This status applies to both traditional Medicaid and Medicaid managed care.

Prescribing providers may obtain coverage of a TNP drug by requesting TNP prior authorization for clients who meet the exception criteria as listed in the TNP Criteria Guide.

Requesting Prior Authorization

Texas Medicaid. Prescribing providers or their representatives should contact the Texas Pharmacy Prior Authorization Call Center to submit a prior authorization request for clients enrolled in Traditional Texas Medicaid.

MCOs. Prescribing providers or their representatives should contact the Medicaid managed care (MCO) prior authorization call center for clients enrolled in MCOs. Prior authorization call center numbers vary by MCO. Use the MCO Search to find the applicable contact information.

Note: TNP prior authorizations are valid for 180 calendar days.

VDP will modify the VDP drug and provisional formulary searches to identify TNP drugs.

Email vdp-formulary@hhsc.state.tx.us with comments or questions.