The Medicaid Comprehensive Care Program (CCP) can cover medically necessary drugs and supplies that are not available through the Vendor Drug Program for people from birth through 20 years of age. Pharmacies not enrolled with CCP should direct the person to call TMHP at 1-800-335-8957 to locate a CCP provider.
Pharmacies that want to enroll should complete an application at tmhp.com. For assistance contact the TMHP Contact Center at 1-800-925-9126, or e-mail TMHP Provider Relations to request assistance from the local TMHP provider relations representative in your area.
Participation allows pharmacies to bill TMHP for medically necessary drugs, equipment, or supplies that are not covered by the Vendor Drug Program (e.g. some over-the-counter drugs, nutritional products, and disposable or expendable medical supplies commonly found in pharmacies).
Prior authorization requirements for services through CCP are found in the TMHP Texas Medicaid Provider Procedures Manual or from the TMHP Prior Authorization CCP unit at 1-800-846-7470.
All CCP services require prior authorization:
For people enrolled in Medicaid managed care, pharmacies must enter into a contract with the person's MCO to be reimbursed for DME and medical supplies or CCP services.
TMHP offers a number of free training seminars each year. All pharmacy staff can view a schedule and register for upcoming workshops at tmhp.com. A free computer-based training module for pharmacy DME providers is available through the TMHP Learning Management System (LMS).