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Learn more about HHSC’s collaboration with AbbVie to combat Hepatitis C in Medicaid.

Latest News

November 30, 2023

Coverage of Commercialized COVID-19 Vaccines through Pharmacy Benefit

November 17, 2023

Synagis Clinical Prior Authorization Forms Updated With Revised Criteria

November 10, 2023

Physician MCO Representative Sought for the Drug Utilization Review Board Until Dec. 1

November 8, 2023

Policy Regarding Health Benefit Plan Coverage Of Prescription Contraceptive Drugs Finalized, Implements Jan. 2024

November 7, 2023

Change in Preferred Drug List Status for the Macrolides-Ketolides Drug Class Effective Nov. 7, 2023

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

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