Texas VDP System Changes For Prescribers 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 Registration

Gainwell will provide an online provider portal in March 2024. The launch date will be provided in a follow-up communication. Registration enables users to submit clinical and preferred (PDL) prior authorizations, check pharmacy prior authorization status, and secure messaging.

Gainwell will provide an online provider portal in March 2024. The launch date will be provided in a follow-up notice, and sign-in credentials will be sent separately via US mail. Registration allows submission of clinical and non-preferred (PDL) prior authorizations, checking prior authorization status, and secure messaging. HHSC will provide details about provider portal user training sessions in a follow-up notice.

You must supply three (3) data elements for portal account activation:

  1. 10-digit National Provider Identifier (NPI) number
  2. Tax ID
  3. Personal Identification Number (PIN)

Upon registration, the Provider portal will assign you a new Trading Partner ID which the system uses to process electronic transactions. It may be requested if you call for technical support. Organizations with multiple billing or pay-to provider IDs only need to create one portal account. You may then add any additional billing providers to your account. You do not need to add Rendering, Ordering, or Referring Physicians.

Prescriber providers who use a third-party billing agent will need an NPI number and the Provider’s PIN. The billing agent will need your PIN to access your information on the portal and will be automatically associated with you.

Technical Support

Gainwell will provide technical support through the Gainwell Technologies Help Desk 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 questions or portal technical support, contact the Gainwell Technologies Help Desk at 800-435-4165, (select option 3).