Texas Medicaid/CHIP Vendor Drug Program
Ingredient cost, Dispensing fee changes coming June 1
May 20, 2016: VDP will change the pharmacy reimbursement methodology for all fee for service (FFS) pharmacy claims effective June 1, 2016. Ingredient costs will differ by the type of pharmacy and methodology will now utilize the National Average Drug Acquisition Cost (NADAC). The dispensing fee will now include a variable component. This change only affects the claims processed by VDP and is not related to and does not impact managed care organization reimbursement rates. More about the pharmacy reimbursement methodology change.
June 17 Deadline Quickly Approaching for Pharmacy Enrollment
May 17, 2016: Pharmacies have less than an month to avoid potential disruption in payment. All pharmacies must submit a complete re-enrollment application packet on or before Friday, June 17, 2016, in order to be re-enrolled by September 24, 2016. HHSC is striving to process all applications expeditiously. Accordingly, the state urges all pharmacies to submit their application as soon as possible. More about the pharmacy enrollment process and applications received after June 17.
What We Do
- Enrolls pharmacy providers that want to provide Medicaid and CHIP services;
- Manages the State of Texas Medicaid and CHIP formularies;
- Processes out-patient pharmacy prescription claims for Medicaid fee-for-service, the Texas Women's Health Program, the DSHS Children with Special Health Care Needs (CSHCN) Services Program, and the DSHS Kidney Health Care (KHC) program.
Watch these multi-part guides to learn about dispensing Texas Medicaid prescriptions, DME, and pharmacy prior authorization:
Chapters include Obtaining a Prior Authorization, Dispensing a 72-hour emergency supply, Confirming eligibility, and Durable medical equipment.
Chapters include Preferred Drug List, E-Prescribing (E-Rx), and 72-hour Emergency Prescription Claims.
STAR Kids starts Nov. 1; Pharmacies should sign up with health plans
May 2, 2016:
STAR Kids will be the first Medicaid managed care program specifically serving youth and children who get disability-related Medicaid. Beginning November 1, 2016, children and youth age 20 or younger will receive all of their services, including prescription benefits, through a STAR Kids health plan. 10 managed care organizations will participate in the STAR Kids program. VDP's pharmacy resources for managed care will be updated closer to implementation. More about STAR Kids.
2016 Texas Pharmacy Association Conference & Expo
April 28, 2016
Stop and visit with VDP staff at the annual Texas Pharmacy Association Conference and Expo, taking place this July in Austin. Learn more about the TPA expo.
Electronic Prescribing of Controlled Substance Allowed In Texas
October 26, 2015
Over 85 percent of Texas pharmacies have the capability for Electronic Prescribing of Controlled Substances (EPCS) prescriptions. Unfortunately, less than 3 percent of Texas prescribers are using EPCS. More about HHSC's state-wide EPCS campaign.
I want to ...
- Search the formulary and drug prior authorization status
- Download the Preferred Drug List
- Learn about managed care
- Review clinical prior authorization criteria
- Submit a 72-hour emergency override
- Learn about continuing education opportunities
- Verify client eligibility
- Access my weekly payment
- Download manuals, forms, and more
- Find a pharmacy
- Find a prescriber