Medicaid Drug Coverage

Texas Medicaid Managed Care Organizations are pivotal in administering comprehensive prescription drug benefits to nearly all Texas Medicaid families—seamlessly coordinating high-quality medical and prescription drug care while saving taxpayer dollars.

Cost Growth Cut in Half

Since shifting prescription drug coverage
in Texas to managed care, national
Medicaid drug costs have increased by 9.7%
annually, while Texas’s growth is only 2.8%.

Improved Outcomes

Coordinating medical and pharmacy benefits together
has reduced risky drug interactions, cut opioid deaths
and decreased ER visits and hospitalizations for
conditions like asthma and diabetes in Texas.

Increased Access to Prescription Drugs

Medicaid and CHIP families in Texas can now use almost any pharmacy in the state, as over 95% of Texas pharmacies are in the Medicaid and CHIP network. From 2013 to 2023, the number of independent pharmacies grew by 16%, resulting in more than 5,000 pharmacies in total. This makes it easier for families to get the prescription drugs they need.

Featured Medicaid Drug Coverage Resources

Medicaid 101

New Texas Medicaid Law Protects Families from Drug Shortages

Medicaid Drug Coverage Resources

All

Policy Papers

TAHP Presentations

101s

Testimonies

Comment Letters

Legislative Briefs

News

TAHP Comments on HB 3286 Temporary Non-Preferred Revised Draft Policy

Comments on PDL Exceptions Rules as Implemented by HB 3286 October 8, 2024

Medicaid Rx 101

Medicaid Drug Coverage Works

Medicaid Drug Coverage 101

Texas Medicaid Managed Care Continues to Deliver on Savings & Outcomes

FDA Approves First State Plan to Import Drugs from Canada

New Texas Medicaid Law Protects Families from Drug Shortages

Medicaid Monday: Texas Medicaid MCOs Save Money on Prescription Drugs for Taxpayers

Testimony On SB 1113: PDL Carve-Out

One-Pager Opposing HB 1293: Mandating Fee-for-Service Pharmacy Rates in Medicaid Managed Care

Testimony Opposing SB 2402: Texas Pharmaceutical Initiative

One-Pager Supporting HB 3286: Patient Prescription Protections in Medicaid

One-Pager Opposing HB 1283: PDL not in Managed Care

Testimony Opposing HB 1283: PDL Outside of Managed care

Testimony Supporting HB 3286: PDL

Dispensing the Facts on the Medicaid Preferred Drug List