December 31, 2020
Beginning in February 2021, Texas Medicaid & Healthcare Partnership (TMHP) will assume pharmacy provider enrollment functions for VDP through a new online provider portal, the TMHP Provider Enrollment and Management System (PEMS). PEMS will be a single tool for enrollment, reenrollment, revalidation, and file maintenance requests. The Texas Health and Human Services Commission (HHSC) will continue to administer claims and payment functions. To use PEMS, VDP pharmacy providers will first need access to the secure features of the TMHP website.
Set Up a TMHP Learning Management System (LMS) Account and a TMHP User Account
VDP pharmacy providers should create TMHP accounts before VDP pharmacy enrollment transitions in February. Note: Pharmacy durable medical equipment (DME) providers should continue to enroll and maintain their information through Provider Enrollment on the Portal (PEP) and the Provider Information Management System (PIMS).
- Set Up a TMHP LMS Account:
- This provider education portal has important training on TMHP systems, user account setup, and how to access and use PEMS. For instructions, refer to the Learning Management System (LMS) Registration and Navigation Job Aid for Providers.
- Set Up a TMHP User Account:
- To create a TMHP User Account, log in to the TMHP LMS and refer to the TMHP Portal Security Training Manual for help creating an account. The manual provides step-by-step instructions on activating and managing TMHP User Accounts.
- Set Up a Separate TMHP User Account—Needed for Associated Provider Accounts:
- VDP providers wanting to activate an existing provider identifier (existing national provider identifier [NPI]) with an existing TMHP User Account to access PEMS, such as an existing acute care account for DME, must follow the instructions in section 2.3 of the TMHP Portal Security Training Manual. In step 2 of this section, providers must select the option Create Account and link to a Vendor Drug Program provider.
VDP pharmacy providers must request a personal identification number (PIN) to link their NPI number to the TMHP User Account. VDP pharmacy providers who did not validate their email with HHSC by the November 20, 2020, deadline will not have the option to request a PIN through email and must receive it by mail.
Enrolled pharmacy providers must revalidate their enrollments at least every five years. As part of revalidation, a full screening is conducted appropriate to the providers’ level of risk for fraud, waste, and abuse. The Centers for Medicare & Medicaid Services designates pharmacies as limited risk providers. The screening will include licensure and background checks using a variety of federal and state databases to verify if providers continue to meet Medicaid enrollment criteria.
VDP pharmacy providers whose revalidations are due on or after March 1, 2021, must submit their applications to TMHP through PEMS.
Providers who do not complete the revalidation process by their deadlines will be disenrolled from Texas Medicaid.
For more information, call the TMHP Contact Center at 800-925-9126.