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Texas Medicaid/CHIP Vendor Drug Program

Pharmacy Field Administration

The Vendor Drug Program maintains 14 field offices across the state to provide assistance and education to Medicaid/CHIP clients, pharmacists, and other health care providers.

 


Field Administration Staff


 

Pharmacy Desk Reviews
The Field Administration offices send letters to pharmacy providers once a month requesting copies of High Dollar, Maximum Allowable Cost (MAC), and Compound prescriptions. Providers are given 25 days from the date of the letter to reply. If the requested copies are not returned within 25 days, the claims are debited.

  • Requirements for MAC claims:
    • Must include the phrase "Brand Necessary," "Brand Medically Necessary," "Brand Name Necessary," or "Brand Name Medically Necessary" written across the face of the prescription in the prescriber's handwriting.
  • Requirements for High Dollar claims:
    • Claims over $1500 must include a copy of the original signed prescription.



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