The Medicaid/CHIP Contract Management unit is responsible for managing over 4,000 pharmacy contracts including reviewing applications, assigning fees, recommending and imposing sanctions, and resolving compliance issues.
Pharmacies that want to participate in the Vendor Drug Program must be contracted prior to providing outpatient pharmacy prescription services to Medicaid clients. Applications will be effective the date the contract is fully executed by both parties. Contracts will not be back-dated. Pharmacies can only submit claims for prescriptions filled on or after the effective date of the contract.
Pharmacies that want to participate in the Children's Health Insurance Program (CHIP), Kidney Health Care (KHC) program, or Children with Special Health Care Needs (CSHCN) Services Program must first have a Medicaid contract. An additional agreement(s) must be signed and returned to Medicaid/CHIP Contract Management unit in order to participate in each of the other programs.
Providers performing medical services that wish to be eligible for reimbursement for Title XIX (Medicaid) benefits must complete the required Medicaid Provider Enrollment Application forms and, if applicable, enter into a written provider agreement. These forms are supplied by the Texas Medicaid & Healthcare Partnership (TMHP) Provider Enrollment department.
If you have any questions regarding the contract process, or you would like to receive a list of software providers who have tested and are registered with Vendor Drug, please contact the Vendor Drug Pharmacy Resolution Desk at 1-800-435-4165 and ask for the Contract Management unit.
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