| (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.
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