Downloads

• Data files
• Documents
• Forms
• Manuals
• Outreach and education resources
• Reports
  • HHSC Quarterly Drug Use and Expenditure Patterns

Managed Care

Most people enrolled in Medicaid and all people enrolled in the Children’s Health Insurance Program receive prescription drug benefits through the managed care delivery model.

• Search managed care organization contact and billing information
• Managed care complaint process
• List of required and optional clinical prior authorizations
• Review the Clinical Prior Authorization Assistance Chart for prior authorizations used by each MCO

Manufacturer Resources

Resources for manufacturers with Texas Medicaid processes for formulary additions, billing, and federal and supplemental rebate programs.

System Transition Resources

In 2023, HHSC announced a contract award to Gainwell Technologies to be the pharmacy benefits administrator for VDP beginning in March 2024.