The Health and Human Services Commission's (HHSC) Vendor Drug Program (VDP) held a Pharmacy Stakeholder meeting and shared the following updates.  

  • Pharmacy Payment Information: VDP emphasized that pharmacies must maintain accurate physical addresses, email addresses, phone numbers and primary contacts in the Texas Medicaid & Healthcare Partnership (TMHP) Provider Enrollment and Management System. Direct deposit changes must be submitted using Form CPA 74-176. Keeping this information current matters because the Comptroller may purge a Texas identification number when no payment or voucher history exists for a full fiscal year.  
  • Continuous Glucose Monitors (CGMs): VDP's planned addition of CGMs to the outpatient drug benefit remains delayed because CMS required pharmacies to enroll as DME suppliers. VDP is seeking removal of the DME requirement and is planning to submit a new state plan amendment (SPA) in November.  
  • Temporary Non-Preferred Drug Rule: VDP implemented the rule required by HB 3286 (2023) that requires new drugs that are available on the formulary but have not yet been reviewed by the Drug Utilization Review (DUR) Board to receive temporary non-preferred status. The related Texas Administrative Code amendment was published in the Texas Register as of October 2 and became effective October 7. Pharmacy organizations should ensure that formulary-management and patient-support teams understand how this temporary status applies while new products await DUR Board review.  
  • Usual and Customary: VDP is developing a Texas Administrative Code amendment to implement House Bill 2402 (2025), a law that excludes fees, charges or rates offered through monthly fee-based membership discount programs from the usual-and-customary fee calculation. VDP stated that the rule must remain limited to the statutory language and cannot extend to third-party discount cards; the exclusion applies only to qualifying membership discount programs.  

Also in Texas, VDP published an update to the VDP Pharmacy Provider Procedure Manual.  

For more information, contact NACDS’ Mary Staples at 817-442-1155.