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 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

• 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