Texas Administrative Code
Title 1 - ADMINISTRATION
Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION
Chapter 354 - MEDICAID HEALTH SERVICES
Subchapter F - PHARMACY SERVICES
Division 1 - PARTICIPATION
Section 354.1807 - Access to Records
Current through Reg. 49, No. 38; September 20, 2024
On request, a pharmacy provider must allow staff of the Health and Human Services Commission, the Texas Office of the Attorney General's Medicaid Fraud Control Unit, and the U.S. Department of Health and Human Services, or their designees, immediate access to financial and other records that pertain to the Medicaid program for review or audit.
(1) The pharmacy provider must give the staff access to and a sample of the prescription files of the provider's non-Medicaid customers to determine the provider's usual and customary price.
(2) The pharmacy provider may remove information that can be used to identify a particular Medicaid client or non-Medicaid customer.
(3) The pharmacy provider must cooperate in regular reviews (general audits and utilization reviews) of the records of its customers who are Medicaid clients.
