VDP coordinates with drug companies to ensure a comprehensive Texas Drug Code Index for the following programs:

  • Medicaid
  • Children’s Health Insurance Program (CHIP)
  • Children with Special Health Care Needs (CSHCN) Services Program
  • Healthy Texas Women (HTW) Program
  • Kidney Health Care (KHC) Program

HHSC requires drug companies to complete a Certificate of Information (COI) for VDP to consider drugs for coverage on the formulary. In early 2021, VDP will implement a browser-based application to replace the paper COI form. Additional information about the electronic COI will be provided is fothcoming.

Documents

Forms

Name Number
Texas Drug Code Index Certification of Information (COI) HHS 1326
Reconciliation of State Invoice CMS-304
Prior Quarter Adjustment Statement CMS-304a
Manufacturer Contact Form (Magellan Medicaid Administration)  
CHIP Drug Rebate Agreement (PDF) HHS 1337
CSHCN Drug Rebate Agreement (PDF) HHS 1343
KHC Program Drug Rebate Agreement HHS 1329
Value-Based Agreement Concept HHS 1402
HHS Data use agreement (PDF)  
HHS Uniform Terms and Conditions (PDF)