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Summary of April 2025 DUR Board Meeting Now Available

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The Texas Drug Utilization Review (DUR) Board met on Friday, April 25, 2025, to recommend Medicaid clinical prior authorizations and drugs for the preferred drug list (PDL). A summary of this meeting is now available on the Texas Vendor Drug Program (VDP) website.

Clinical Prior Authorization Reminders

The following are reminders for clinical prior authorizations:

PDL Reminders

The following are reminders for the PDL:

  • All PDL recommendations are pending until the Texas Health and Human Services Commission (HHSC) executive commissioner releases the final decisions. HHSC will incorporate the decisions from the January 2025 and April 2025 board meetings into the PDL that will be published in July 2025.
  • Prescribing providers must use the Medicaid formulary and PDL.
  • MCOs should adhere to the Medicaid formulary and PDL. Providers should evaluate a drug’s formulary status before its preferred status.

Retrospective DUR Reminders

The retrospective DUR periodically examines claims data and other records to identify patterns of fraud, abuse, gross overuse, or inappropriate or medically unnecessary care made by prescribing providers, pharmacists, and people associated with specific drugs or groups of drugs. The retrospective review also allows for active and ongoing educational outreach to educate prescribing providers on common drug therapy problems to improve prescribing or dispensing practices.

About the Texas DUR Board

The board’s next meeting is scheduled for Friday, July 25, 2025. Board members meet quarterly in Austin to recommend outpatient prescription drugs for Texas Medicaid. The schedule of upcoming meetings, instructions on submitting written materials to the board, and information about publicly testifying in front of the board are available on the VDP website.

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