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TITLE 1ADMINISTRATION
PART 15TEXAS HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 354MEDICAID HEALTH SERVICES
SUBCHAPTER FPHARMACY SERVICES
DIVISION 8DRUG UTILIZATION REVIEW BOARD
RULE §354.1941Drug Utilization Review Board

(a) The Drug Utilization Review Board (DUR Board) shall:

  (1) develop recommendations for preferred drug lists to be adopted by the Health and Human Services Commission (HHSC);

  (2) suggest to HHSC restrictions or clinical prior authorizations on prescription drugs;

  (3) recommend to HHSC educational interventions for Medicaid providers;

  (4) review drug utilization across Medicaid; and

  (5) perform other duties that may be specified by law and otherwise make recommendations to HHSC.

(b) DUR Board membership.

  (1) In accordance with the provisions of Texas Government Code §531.0736 and Social Security Act §1927(g)(3), the DUR Board is appointed by the Executive Commissioner and consists of at least 17 physicians and pharmacists, one consumer advocate who represents Medicaid recipients, and two non-voting managed care organization representatives.

  (2) To apply to be a member of the DUR Board, a person submits a completed application and required documents in accordance with the application instructions posted on HHSC's website prior to the posted deadline.

(c) DUR Board meetings.

  (1) HHSC publishes notice of meetings of the DUR Board. Each notice includes the categories to be considered at the upcoming meeting, instructions concerning filing of written comments, and application to provide public testimony before the board. Testimony is provided in a public forum.

  (2) The board will not discuss or disclose information deemed confidential under Texas Government Code §531.071 in a public session.

(d) The DUR Board or its designee must present a summary of any clinical efficacy and safety information or analyses regarding a drug under consideration for a preferred drug list that is provided to the DUR Board by a private entity that has contracted with HHSC to provide the information. The board or the board's designee shall provide the summary in electronic form before the public meeting at which consideration of the drug occurs. Confidential information described by Texas Government Code §531.071 must be omitted from the summary. The summary must be posted on HHSC's website.

(e) Subject to HHSC's approval, the DUR Board will develop by-laws governing the conduct of DUR Board meetings, including the receipt of public testimony and procedures by which it makes advisory recommendations. HHSC or its designee will publish these by-laws on HHSC's website.


Source Note: The provisions of this §354.1941 adopted to be effective February 9, 2016, 41 TexReg 960

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