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
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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