- (a) To participate in a health care MCO's network, a pharmacy provider must be licensed with the Texas State Board of Pharmacy, have a national provider identifier, and be enrolled as a Medicaid provider with HHSC. To provide services to a member of a MCO when the member is located in another state, the pharmacy provider must be licensed 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 §309.3 (relating to Generic Substitution).
Source Note:The provisions of this §353.909 adopted to be effective March 1, 2012, 37 TexReg 1292; amended to be effective September 1, 2014, 39 TexReg 5873.