Texas Medicaid/CHIP Vendor Drug Program
Pharmacy Providers and the Affordable Care Act
June 19, 2015
Texas Medicaid is complying with the provisions of the Affordable Care Act (ACA), which affects the enrollment of Texas Medicaid providers, including pharmacies. Read more about the ACA changes for pharmacy.
Makena Added as a Medicaid Pharmacy Benefit
June 5, 2015
Beginning June 15, Makena® (hydroxyprogesterone caproate injection) will be available as a pharmacy benefit through the Texas Medicaid Vendor Drug Program. More about the Makena pharmacy benefit.
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.
I want to ...
- Search the formulary and drug PA status
- Download the Preferred Drug List
- Learn about managed care
- Review clinical edit criteria
- Submit a 72-hour emergency override
- Learn about continuing education opportunities
- Verify client eligibility
- Access my weekly payment
- Download manuals, payer sheets, forms, and more
- Find a pharmacy
- Find a prescriber