Texas Medicaid/CHIP Vendor Drug Program
Medicaid Managed Care Expansion Resources
2012-2013 RSV Season Extended to March 31, 2013
February 13, 2013
Due to high levels of Respiratory Syncytial Virus (RSV) statewide, the Texas Health and Human Services Commission will extend the palivizumab season through March 31, 2013, for all counties. More on the 2012-13 RSV Season.
Preferred Drug List Changes effective January 23, 2013
January 22, 2013
New Enforcement Date of Amended Texas Administrative Code Rules
January 9, 2013
HHSC is postponing the enforcement of the following amended Texas Administrative Code rules until March 1, 2013:
- § 1 TAC §354.1901, Pharmacy Claims
- § 1 TAC §354.1921, Addition of Drugs to the Texas Drug Code Index
- § 1 TAC §354.1923, Review and Evaluation
- § 1 TAC §354.1927, Retention and Deletion of Drugs
- § 1 TAC §355.8541, Legend and Non-legend Medication
- § 1 TAC §355.8542, Drug Price Effective Date
The effective date of the amended rules is January 14, 2013. HHSC is postponing enforcement of the rules and the requirement to use the new “Certification of Information” document until March 1, 2013. This delay will give manufacturers additional time to make changes to business practices or procedures to comply with the rules.
If you have any questions about VDP’s price reporting requirements, including HHSC’s postponed enforcement of the amended rules, please contact the Vendor Drug Program.
Medicaid Coverage of Barbiturates and Benzodiazepines for Medicare Part D Dual Eligible Clients
December 20, 2012
Effective January 1, 2013, Texas Medicaid will no longer cover barbiturates and benzodiazepines as part of the wraparound benefit for Medicaid clients who are also covered by a Medicare Part D plan (dual eligible). Pharmacies who submit claims for these drugs, for dual eligible clients, with a date of service on or after January 1, 2013, will be rejected (Error Code 41: “MEDICARERX covered drug class Call Medicare 1-800-633-4227”).
Section 1860D- 2(e)(2)(A) of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) was amended to include barbiturates “used in the treatment of epilepsy, cancer, or a chronic mental health disorder” and benzodiazepines. MIPPA further specified that these amendments apply to prescriptions dispensed on or after January 1, 2013. Like any other prescription drug covered under the Part D benefit program, barbiturates and benzodiazepines must meet all other conditions for Part D drugs found in §423.100.