Texas

The Health and Human Services Commission (HHSC) Vendor Drug Program (VDP) now covers the 2023-2024 Pfizer-BioNTech, Moderna and Novavax commercial COVID-19 vaccines as a pharmacy benefit for both Medicaid managed care and fee-for-service, as well as the Children’s Health Insurance Program (CHIP). 

Also in Texas, Medicaid will perform the semi-annual update of the Medicaid preferred drug list on January 25, 2024. The Health and Human Services Commission (HHSC) made the PDL changes based on recommendations made at the October 2023 Drug Utilization Review Board meeting. Drug list recommendations from the meeting are available. 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 (408-D8). Refer to the Dispense as Written section of the Formulary Coverage chapter of the Pharmacy Provider Procedure Manual for more information. 

Also in Texas, the Health and Human Services Commission (HHSC) is soliciting comments on the prospective clinical prior authorization proposals likely to be presented at the Texas Drug Utilization Review (DUR) Board meeting on January 26, 2024. The board reviews and recommends clinical criteria and the preferred or non-preferred drug status on the Medicaid formulary.  

Also in Texas, December 11 was the filing deadline for the March 5, 2024, primary election.  

For more information, contact NACDS’ Mary Staples at 817-442-1155.