P-2.1. Vendor Drug Program

P-2.1.1. Program Information

Mailing Address

Vendor Drug Program (MC-2250)

Texas Health and Human Services

701 W. 51st St., Austin, TX 78751

Visitor information and directions

Telephone

800-435-4165 - Pharmacy Benefits Access Help Desk

Monday to Friday, 8:30 a.m. to 5:15 p.m. (central)

This number is only for pharmacy providers. Have your pharmacy’s 10-digit National Provider Identifier (NPI) number and the appropriate cardholder ID number ready to expedite your call.

Fax

512-730-7483 - central office

512-491-1958 - help desk

Website

www.txvendordrug.com

The VDP website includes news, information, and resources needed for pharmacy participation in Texas Medicaid. All content is free, and no account is necessary to access services. We encourage all pharmacy staff to provide the proper education and instruction so your staff may take full advantage of these resources.

P-2.1.2. Pharmacy Enrollment and Support

Telephone

800-435-4165 - Pharmacy Benefits Access Help Desk

Request transfer to pharmacy enrollment section.

Fax

512-730-7477

Email

vdp-enrollment@hhsc.state.tx.us

P-2.1.3. Pharmacy Claim Processing

Telephone

800-435-4165 - Pharmacy Benefits Access Help Desk

Have your pharmacy’s 10-digit National Provider Identifier (NPI) number and the appropriate cardholder ID number ready to expedite your call.

P-2.1.4. Eligibility Verification Portal

Telephone

888-701-1713 - Conduent Technical Support and Interfaces Desk

Monday to Friday, 8:00 a.m. to 5:30 p.m. (central)

Fax

866-780-2185

Website

https://txpcra.pharmacy.services.conduent.com/PBMPortal/login.jsp

Refer to the Eligibility Verification Portal section of this manual to learn more about real-time eligibility verification. Refer to the Eligibility Verification (E1) Transaction section to learn how to use these tools to identify people eligible for Medicaid or CHIP.

P-2.1.5. Third-party Recovery

Telephone

866-389-5594 - Texas Third-party Call Center

Monday-Friday, 8:30 a.m. to 5:15 p.m. (central)

Call center staff will verify requests within three business days and provide pharmacy staff with updates to allow for claim processing.

P-2.1.6. Drug Pricing

For Medicaid fee-for-service pricing inquires contact CMS. VDP no longer uses the maximum-allowable cost (MAC).

Telephone

855-457-5264

Fax

844-860-0236

Pharmacy staff are encouraged to fax a copy of the manufacturer's invoice

Email

info@mslcrps.com

Website

medicaid.gov/medicaid/prescription-drugs/retail-price-survey/

Pharmacy providers should use the NADAC Request for Medicaid Reimbursement Review (PDF) to submit NADAC pricing inquiries. You must complete all fields for proper submission of this form. Do not include any personal health information (PHI) on your submitted form or invoice.

P-2.1.7 Pharmacy Prior Authorization

P-2.1.7.1. Clinical Prior Authorization

Telephone

877-PA-TEXAS (877-728-3927) - Texas Prior Authorization Call Center

Monday to Friday, 7:30 a.m. to 6:30 p.m. (central)

Fax

866-469-8590

P-2.1.7.2. Non-preferred Prior Authorization

Telephone

877-PA-TEXAS (877-728-3927) - Texas Prior Authorization Call Center

Monday to Friday, 7:30 a.m. to 6:30 p.m. (central)

Fax

866-469-8590

Website

paxpress.txpa.hidinc.com

Select the "PA Request" tab at PAXpress, the Texas Prior Authorization Call Center Portal.

P-2.1.7.3. Program Review

Mailing Address

Attention: DUR/Formulary Management

Vendor Drug Program (MC-2250)

Texas Health and Human Services

701 W. 51st St., Austin, TX 78751

Fax

512-491-1962

P-2.1.7.5. Technical Helpdesk

Telephone

334-321-0177 - Texas Prior Authorization Technical Helpdesk

Monday to Friday, 7:30 a.m. to 6:30 p.m. (central)

Users call when Texas Prior Authorization portal or other resources are offline or unavailable

P-2.1.8. Pharmacy Payment File Portal

Telephone

888-701-1713 - Conduent Technical Support and Interfaces Desk

Monday-Friday, 8:00 a.m. to 5:30 p.m. (central)

Fax

866-780-2185

Website

moveit.services.conduent.com

Refer to the Payment File Portal section to learn more about the features of the portal.

P-2.1.9. Pharmacy Refunds

Mailing Address

Accounts Receivable Tracking System (BH-1470)

Texas Health and Human Services

Attention: VDP Refunds

701 W. 51st St., Austin, Texas 78751

Physical Address

Accounts Receivable Tracking System (BH-1470)

Texas Health and Human Services

Attention: VDP Refunds

P. O. Box 149055, Austin, Texas 78714

P-2.1.10. Fraud, Waste and Abuse Reporting

Mailing Address

HHSC Inspector General

Texas Health and Human Services

P.O. Box 85200, Austin, TX 78708-5200

Physical Address

HHSC Inspector General

Texas Health and Human Services

11501 Burnet Road, Building 902, Austin, TX 78758

Telephone

800-436-6184 - IG Integrity Line

Website

oig.hhs.texas.gov