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Texas MedicaidMedicaid · Coverage · Pharmacy · TX · PharmacyMedium impact

Foundayo to Be Removed From the Texas Medicaid Formulary Effective October 30, 2026

Act
by Oct 30, 2026
Effective date
Oct 30, 2026
Identified
Oct 24, 2026

Summary

Texas Medicaid (HHSC Vendor Drug Program) is removing Foundayo from the formulary effective October 30, 2026, due to erroneous addition on September 20, 2026. All NDCs for Foundayo tablets (0.8 mg through 17.2 mg) will lose provisional coverage status, making the drug non-covered for Texas Medicaid beneficiaries.

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What to do

by Oct 30, 2026 · 4 steps
01Billing team must update pharmacy systems and prior authorization workflows to reflect that all Foundayo NDCs (00002417801, 00002417831, 00002450301, 00002450331, 00002479401, 00002479431, 00002480301, 00002480331, 00002483901, 00002483931, 00002495301, 00002495331) are no longer covered under Texas Medicaid.
02Review any pending or standing prescriptions for Texas Medicaid patients and communicate delisting to prescribers and the dispensing pharmacy.
03Claims submitted after October 30, 2026, for these NDCs will be denied as non-formulary.
04Contact vdp-formulary@hhsc.state.tx.us with questions regarding the removal.

Original notice

Foundayo to Be Removed From the Texas Medicaid Formulary Effective October 30, 2026
tmhp.com · Always check the source before changing claims.
View original ↗

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