TMPPM 2008 > Appendices > Vendor Drug Program > Vendor Drug Program (VDP)

E.1 Vendor Drug Program (VDP)

The Texas Medicaid Vendor Drug Program (VDP) makes payment for prescriptions of covered outpatient drugs only to those pharmacy providers contracted with the VDP. In-state pharmacies licensed as Class A or C by the Texas State Board of Pharmacy are eligible for enrollment in the VDP. Out-of-state pharmacies and pharmacies holding any other class of pharmacy license are considered for inclusion in the program on a case-by-case basis, relative to the benefits made available to a client eligible for Medicaid. Contracts are not granted to applicants unless additional benefits to the recipient are established.

The only drugs eligible for VDP reimbursement are listed in the current Texas Listing of National Drug Codes. Additionally, the Texas Drug Code Index (TDCI) can be found on the HHSC website at www.hhsc.state.tx.us. The VDP does not reimburse claims for nutritional products (enteral or parenteral), medical supplies, or equipment.

For more information on the VDP, contact:

The Texas Medicaid Preferred Drug List is now available on the Epocrates drug information system. The service is free and provides instant access to information on the drugs covered by the Texas formulary on a Palm or Pocket PC handheld device. To register for the service, go to the Epocrates website at www.epocrates.com/products/ and sign up for Epocrates Rx.

Clients who are not locked-in to a specific pharmacy may obtain their drugs or supplies from any contracted Medicaid provider of pharmaceutical services.

Refer to: "Client Limited Program" on page 4-5 for more information about lock-in limitations.

Family planning services are excluded from lock-in limitation. Though TMHP reimburses family planning agencies and physicians for family planning drugs and supplies, the following family planning drugs and supplies are also available through the VDP:

•Diaphragms.

•Oral contraceptives.

•Jellies, creams, foams, suppositories, vaginal contraceptive film, and contraceptive sponge.

•Condoms.

•Medication for treatment of vaginal/cervical/genital infections (subject to the three prescription limit).

The VDP is limited to three prescriptions per month, per client, except for:

•Clients enrolled in waiver programs such as managed care, Class, Community-Based Alternatives (CBA).

•Texas Health Steps (THSteps)-eligible (clients younger than 21 years of age), unlimited but must be medically necessary and appropriate.

•Residents in skilled nursing facilities, unlimited.

•Clients enrolled in the State of Texas Access Reform (STAR) Program, and residing in a STAR Program service area, unlimited.

Refer to: "Service Area and STAR HMO Choices" on page 7-16

•Prescriptions for family planning drugs and supplies are not subject to the three prescription limit.