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 353.915 - Access to Network Pharmacies

(a) A health care managed care organization (MCO) must ensure that a member has access to at least one network pharmacy within 15 miles from his or her residence.

(b) A health care MCO must ensure that a member has access to at least one network pharmacy with 24-hour coverage within 75 miles of his or her residence.

(c) If a network pharmacy provider is not available to a member within the mileage radius specified in subsection (a) or (b) of this section, the health care MCO must submit to the Health and Human Services Commission for approval data that indicates covered outpatient pharmacy services are not available to the member within the required distance.