Texas Administrative Code
Title 1 - ADMINISTRATION
Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION
Chapter 353 - MEDICAID MANAGED CARE
Subchapter J - OUTPATIENT PHARMACY SERVICES
Section 353.909 - Participating Pharmacy Providers
Current through Reg. 49, No. 38; September 20, 2024
(a) To participate in a health care MCO's network, a pharmacy provider must be licensed with the Texas State Board of Pharmacy or, with respect to a patient located in another state, with the pharmacy licensing entity in that state, have a national provider identifier, and be enrolled as a Medicaid provider with HHSC.
(b) A pharmacy provider is subject to the Vendor Drug Program rules in Chapter 354, Subchapter F, Division 1 and Division 5 of this title (relating to Participation; and Audits).
(c) The prescription requirements in § 354.1863(a), (b), and (d) of this title (relating to Prescription Requirements) apply to all pharmacy providers.
(d) Except as prohibited by the health care MCO, a pharmacy provider may substitute one covered outpatient drug for another covered outpatient drug in a prescription only if authorized by the prescribing physician in accordance with 22 TAC § RSA 309.3(relating to Generic Substitution).
