Texas VDP System Changes For Pharmacies Begins March 2024

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On Oct. 13, 2023, the Texas Health and Human Services Commission (HHSC) announced a contract award to Gainwell Technologies (Gainwell) to be the pharmacy benefits administrator for the Texas Vendor Drug Program (VDP).

Beginning Saturday, March 30, 2024, Gainwell will be responsible for the following functions:

  • Fee-for-service Medicaid and other state program pharmacy claims processing.
  • Administration of Medicaid federal, supplemental, and value-based rebate program.
  • Preferred drug list management.
  • Fee-for-service Medicaid and other state program pharmacy prior authorization administration.
  • Formulary management, including the electronic Certificate of Information (eCOI) for VDP formulary additions.
  • Prospective and retrospective drug utilization review activities.
  • Pharmacy, prior authorization, and technical call centers.

VDP Provider Portal

Gainwell will provide an online provider portal in March 2024. The launch date will be provided in a follow-up communication. The purpose of the portal is to:

  • Access Electronic Remittance Advices and 835 for weekly payments.
  • Check the status of prior authorizations submitted by prescribers.
  • Read general pharmacy announcements.
  • Receive pharmacy-specific notifications.

Gainwell will notify pharmacies by mail with the portal link and credentials before March 30, 2024. In addition, Gainwell will provide portal user training sessions.

Payer Sheets

VDP will publish and notify pharmacies, software companies, and switch vendors of the revised payer sheets by Jan. 31, 2024.

Technical Support

Gainwell will provide technical support through the Gainwell Technologies Call Center on the following days (all times central):

  • Saturday, March 30, 2024:
    • 8:00 a.m. to 5:00 p.m.
  • Sunday, March 31, 2024:
    • 9:00 a.m. to 5:00 p.m.
  • Regular operation hours begin Monday, April 1, 2024:
    • Monday to Friday, 7:00 a.m. to 7:00 p.m.

Resources

The System Transition Resources page will provide notices and information about this change. You can also register with the HHSC email notification service to review emails from VDP about the change.

Beginning March 30, 2024, for pharmacy questions or portal technical support, contact the Texas Medicaid Pharmacy and Technical Call Center at 800-435-4165, (select option 3).