What We Do

• Enroll pharmacy providers that want to provide Medicaid and CHIP services;
• Manage the state Medicaid and CHIP formularies;
• Process out-patient pharmacy prescription claims for people enrolled in traditional Medicaid, the Children with Special Health Care Needs (CSHCN) Services Program, the Healthy Texas Women (HTW) Program, and Kidney Health Care (KHC) program.

• Enroll my pharmacy with Texas Medicaid
• Participate in Medicaid managed care
• Access my weekly payment

• Search for covered drugs and products
• Review clinical prior authorizations or the preferred drug list
• Submit a 72-hour emergency override
• Find a pharmacy or prescribing provider

• Verify client eligibility
• Review the Pharmacy Provider Procedure Manual
• Learn about the Texas Drug Utilization Review Board
• Receive email notices from Texas Medicaid
• Contact the Vendor Drug Program