TMPPM 2008 > Texas Medicaid Services > Texas Health Steps (THSteps) > THSteps-Comprehensive Care Program (CCP)

43.4.11 Pharmacies (THSteps-CCP Only)

43.4.11.1 Enrollment

Pharmacy providers are eligible to participate in THSteps-CCP. To be enrolled in THSteps-CCP, the pharmacy must also be enrolled in VDP.

Pharmacy providers currently enrolled with VDP are also enrolled in THSteps-CCP with TMHP. This enrollment allows pharmacy providers to bill for those medications and supplies payable by Medicaid for clients younger than 21 years of age but not covered by VDP (e.g., some over-the-counter drugs, diapers, and disposable or expendable medical supplies). Pharmacy providers must continue to bill HHSC for drugs covered under VDP.

Direct questions about VDP to 1-800-435-4165.

Pharmacies that wish to supply disposable or expendable medical supplies or DME must be enrolled as DMEH providers and should obtain these items through the Home Health Services Unit.

Important: All providers are required to read and comply with Section 1, Provider Enrollment and Responsibilities. In addition to required compliance with all requirements specific to the Texas Medicaid Program, it is a violation of Texas Medicaid Program rules when a provider fails to provide health-care services or items to Medicaid clients in accordance with accepted medical community standards and standards that govern occupations, as explained in 1 TAC §371.1617(a)(6)(A). Accordingly, in addition to being subject to sanctions for failure to comply with the requirements that are specific to the Texas Medicaid Program, providers can also be subject to Texas Medicaid Program sanctions for failure, at all times, to deliver health-care items and services to Medicaid clients in full accordance with all applicable licensure and certification requirements including, without limitation, those related to documentation and record maintenance.

Refer to: "Provider Enrollment" for more information about enrollment procedures.

"Texas Medicaid (Title XIX) Home Health Services" for details about coverage through Texas Medicaid (Title XIX) Home Health Services.