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Important Update Actualización importante:

Good news! All CHIP, STAR, and STAR Kids Member Handbooks are now available online. Quick, easy access to your benefits and coverage information - any time!

¡Buenas noticias! Todos los manuales para miembros de CHIP, STAR y STAR Kids ya están disponibles en línea. Obtén acceso rápido y sencillo a la información sobre tus beneficios y cobertura, ¡en cualquier momento!

Medicaid Preferred Drug List and Formulary Changes Cambios en el formulario y la lista de medicamentos preferidos de Medicaid

The Vendor Drug Program (VDP) made changes to the Texas Medicaid drug formulary effective July 24, 2026. To learn more about formulary changes impacted, please click here for more information.

El programa de medicamentos de proveedores de Texas (VDP) ha realizado cambios recientes en el formulario de medicamentos de Medicaid de Texas. Esto entrará en vigencia el 24 de julio de 2026. Para obtener más información sobre los cambios en el formulario afectados, visite el siguiente enlace para obtener más información.

Telemedicine Information Updated in the Texas Medicaid Provider Procedures Manual

Date: July 24, 2025

Attention: Providers

Effective date: September 1, 2025

Call to action: The purpose of this communication is to make providers aware that on September 1, 2025, the Texas Medicaid & Healthcare Partnership (TMHP) will update telemedicine information in the following subsections of the Texas Medicaid Provider Procedures Manual (TMPPM), Telecommunication Services Handbook:

On September 1, 2025, the Texas Medicaid & Healthcare Partnership (TMHP) will update telemedicine information in the following subsections of the Texas Medicaid Provider Procedures Manual (TMPPM), Telecommunication Services Handbook:

  • Subsection 3.1, “Patient Health Information Security”—TMHP will remove the reference to the requirement stating that a health professional must be present with the child for school-based telemedicine.
  • Subsection 3.4.1, “Distant Site”—TMHP will remove the reference to out-of-state physicians to align with the recently amended Texas Administrative Code (TAC) rules relating to telemedicine services.
  • Subsection 3.4.2.1, “Prescriptions Generated from a Telemedicine Medical Service”—TMHP will update the TAC rule references for the treatment of clients with acute pain and compliance requirements for prescriptions issued through a telemedicine service.

Link to Texas Medicaid Provider Procedures Manual: https://www.tmhp.com/resources/provider-manuals/tmppm

Texas Medicaid managed care organizations (MCOs) like Texas Children’s Health Plan must provide all medically necessary, Medicaid-covered services to Medicaid members who are enrolled in their MCO/TCHP. Administrative procedures, such as prior authorization, precertification, referrals, and claims and encounter data filing, may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers should reference a member’s specific MCO/TCHP for information on these items. For TCHP, this information can be found on the provider page available here https://www.texaschildrenshealthplan.org/providers.

Next step for Providers: Providers should share this communication with their staff.

If you have any questions, please email Provider Relations at: providerrelations@texaschildrens.org

For access to all provider alerts: www.texaschildrenshealthplan.org/provideralerts.