System Transition Resources

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 federal, supplemental, and value-based rebates
  • Preferred drug list and value-based rebate negotiations
  • Fee-for-service Medicaid and other state program pharmacy prior authorization administration
  • Formulary management, including the electronic Certificate of Information for formulary addition
  • Drug utilization review activities
  • Pharmacy, prior authorization, and technical call centers

Pharmacy enrollment will continue unchanged through TMHP.

Resources for Pharmacies

Resources for Drug Manufacturers

Resources for Prescribing Providers