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Latest News

June 9, 2023

MCO Search Now Available

May 31, 2023

Removal of Quantity Limits for Hepatitis C Medications, Including Mavyret Preferred Hepatitis C Treatment

May 19, 2023

HHSC to Implement Pulmonary Hypertension Agents Clinical Prior Authorization on July 27, 2023
HHSC to Implement Sotyktu Criteria in Cytokine and CAM Antagonists Clinical Prior Authorization on July 27, 2023

May 17, 2023

Members Sought for the Drug Utilization Review Board

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