MedicaidPrior AuthMedium impact
Expanded Drug List and New Prior Authorizations for HTW Effective July 1, 2026
Texas Medicaid·TX · OB-GYN, Family Medicine, Internal Medicine·Pharmacy
Effective date
Jul 1, 2026
We identified it
Apr 13, 2026
Summary
Starting July 1, 2026, Texas Medicaid's Healthy Texas Women (HTW) program will expand drug coverage to include all Medicaid-eligible drugs in currently covered health categories, applying the same prior authorization and preferred drug list rules as regular Medicaid. This change aligns HTW with federal Medicaid requirements as the program transitions from state to federal funding.
Action Required
Before July 1, 2026: Billing team must update prior authorization procedures for HTW patients to match Medicaid requirements. Update workflow to check preferred drug list (PDL) for HTW pharmacy claims and obtain clinical prior authorizations using same process as regular Medicaid. Contact vdp-policy@hhs.texas.gov for specific formulary updates and visit HTW website for program details.