What We Do
- Manage the state Medicaid and CHIP formularies
- Process out-patient pharmacy claims for people enrolled in traditional Medicaid, the Children with Special Health Care Needs Services Program, the Healthy Texas Women Program, and Kidney Health Care Program
Latest News
June 22, 2022
I want to:
- Enroll a pharmacy through the Provider Enrollment and Management System (PEMS)
- Participate in managed care
- Enroll a drug with Medicaid
- Learn about the drugs and products available on the formularies
- Search for outpatient drugs and products and clinician-administered drugs
- Find a pharmacy or prescribing provider
- Access my pharmacy's weekly payment
- Review clinical prior authorizations or the preferred drug list
- Submit a 72-hour emergency override claim
- Reference the Pharmacy Provider Procedure Manual
- Reference the Drug Manufacturer Manual
- Attend the Texas Drug Utilization Review Board
- Contact us