Texas Medicaid/CHIP Vendor Drug Program
Medicaid Managed Care Expansion Resources
Effective June 1, 2012, Medicaid and CHIP Managed Care Organizations (MCOs) will begin paying local pharmacies to deliver pharmaceuticals to clients. Each MCO will develop its own participating pharmacy network for this delivery service. Pharmacies interested in receiving payment for the delivery of pharmaceuticals should contact their MCOs to request information on how to apply.
The Vendor Drug Program website has several managed care expansion resources for pharmacies. Please refer to the Enrollment Chart for the pharmacy contract phone number for each MCO.
April 2, 2012
Effective March 1, 2012, most Medicaid clients and all Children’s Health Insurance Program (CHIP) clients receive their prescription drug benefits through the managed care service delivery model. More on Managed Care changes | Frequently Asked Questions (PDF)
Resources for pharmacies:
Pharmacy notification letter | MCO/PBM by county/service area | Billing Assistance chart | Enrollment chart | Vendor Drug Eligibility Verification Portal (EVP).
Resources for prescribers:
Prescriber notification letter | Prescriber Assistance chart
News Highlights
Medicaid Coverage of Medicare Part B Immunosuppressant Drugs
April 2, 2012
Medicaid clients who are also covered by Medicare Part B may have all or a portion of their co-insurance and deductible amounts paid by Medicaid. More on Medicare Part B coverage.
Suggestions for Pharmacies During MCO Transition
March 2, 2012
The Pharmacy Resolution Help Desk has guidance for pharmacies to assist them with trends related to the implementation of the Medicaid and CHIP transition to managed care. More on MCO Transition.
Eligibility Verification Tools for MCO Transition
February 24, 2012
Pharmacies have multiple methods available to determine whether a client is eligible or enrolled in a managed care plan. More on Eligibility Verification Tools.
