MedicaidPrior AuthMedium impact
Summary of April 2026 DUR Board Meeting Now Available
Texas Medicaid·TX·General
Effective date
Jul 1, 2026
We identified it
May 23, 2026
Summary
The Texas Drug Utilization Review Board met in April 2026 and made recommendations for Medicaid clinical prior authorizations and preferred drug list changes. Final decisions will be incorporated into the PDL published in July 2026, with different requirements for traditional Medicaid versus Medicaid managed care organizations.
Action Required
By July 2026: Billing and clinical teams must review the updated Texas Medicaid formulary and preferred drug list when published. Use the MCO search tool to identify each managed care organization's specific prior authorization requirements, as they differ from traditional Medicaid. Verify formulary status before checking preferred status for all Medicaid prescriptions.