Effective Saturday, March 30, 2024, Gainwell Technologies, LLC (Gainwell) will be the pharmacy benefits administrator for the Texas Vendor Drug Program (VDP). The Texas Health and Human Services Commission (HHSC) announced the contract award to Gainwell in 2022.
Effective March 30, 2024, Gainwell will be responsible for the following functions:
- Fee-for-service Medicaid and other state program pharmacy claims processing
- Administration of the Medicaid federal, supplemental, and value-based rebate program
- Preferred drug list (PDL) management
- The pharmacy prior authorization administration of fee-for-service Medicaid and other state programs
- Formulary management, including the electronic Certificate of Information (eCOI) for VDP formulary additions
- Prospective and retrospective drug utilization review activities
- Management of pharmacy, prior authorization, and technical call centers
VDP Provider Portal
Gainwell will launch an online provider portal in March 2024. Registered users can use the portal to submit clinical and non-preferred prior authorizations, check prior authorization status, and send secure messages.
Details about the provider portal launch date and user training sessions will be provided in a follow-up communication.
Gainwell will provide technical support through the Gainwell Technologies Help Desk beginning Saturday, March 30, 2024, from 8 a.m. to 5 p.m.
Email VDP-PBS-Modernization@hhsc.state.tx.us with comments or any questions.
Refer to the System Transition Resources page on the VDP website for more information about Gainwell’s online provider portal and the help desk.