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Summary of October 2025 Drug Utilization Review Board Meeting Now Available

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The Texas Drug Utilization Review (DUR) Board met on Friday, October 24, 2025, to recommend Medicaid clinical prior authorizations and drugs for the preferred drug list. A summary of this meeting is now available from the Texas Vendor Drug Program (VDP) website.

Clinical Prior Authorization Updates

The following are reminders for clinical prior authorizations:

Preferred Drug List Updates

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

  • All PDL recommendations are pending until the Texas Health and Human Services Commission (HHSC) executive commissioner releases the final decision. HHSC will incorporate the approved decisions from the July and October 2025 board meetings into the PDL that will be published in January 2026.
  • 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.

Retrospective DUR Criteria Updates

Retrospective DUR provides for ongoing and periodic examination of claims data and other records to identify patterns of fraud, abuse, gross overuse, or inappropriate or medically unnecessary care among 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 next board meeting will be held on Friday, January 23, 2026. Board members meet quarterly in Austin to recommend outpatient prescription drugs in the Texas Medicaid program. The schedule of upcoming meetings, instructions on submitting written materials to the board, and directions about publicly testifying in front of the board are available on the VDP website.

Email vdp-advisory@hhs.texas.gov with comments or any questions.