THMP – Participating Pharmacy Frequently Asked Questions
How can my pharmacy sign up to become a THMP Participating Pharmacy?
Please fill out the Request to Become a THMP Participating Pharmacy form and the Vendor Information Form and fax both to 512-533-3178, or mail to THMP at:
Post Office Box 149347, MC 1873
Austin, TX 78714-9347
To participate with THMP, your pharmacy must have a license in good standing with the Texas State Board of Pharmacy; be open to the general public; and be located in an area not currently served by a participating pharmacy.
If there is a participating pharmacy in your area, but there is a demonstrated need for another, please provide a letter of justification from the organization that would like to refer clients to your pharmacy. If your pharmacy qualifies to become a THMP participating pharmacy, you will receive a Memorandum of Agreement at the email address you provide. If your pharmacy does not qualify, you will receive a letter detailing the reasons for denial.
If my pharmacy’s Signature Authority is a different person from the Pharmacist in Charge, how do I indicate that on the Memorandum of Agreement?
The current Memorandum of Agreement does not require the Pharmacist in Charge to be the Signature Authority. However, please indicate on the Request to Become a THMP Participating Pharmacy form if your Signature Authority is different from the PIC.
If I make a typo on the Request to Become a Participating Pharmacy form, how can I correct that?
Please make a single strikethrough on the error and initial the change to indicate that you approve the change.
What happens if the medication is shipped to us expired or will expire before completely taken by the guest (does this fall under the discrepancy issue)?
Under normal circumstances this shouldn’t happen, as we order our shipping stock from the wholesaler on a weekly basis and only keep limited inventory on the shelf for most items. If the situation does occur, however, the pharmacy should notify THMP staff as to the lot number and expiration date of the item in question, who will check with DSHS Pharmacy staff to verify that the item came from our inventory and make arrangements to dispense additional medication for that patient.
My pharmacy has 340B designation. May I file for 340B rebates for medications received through THMP?
No, THMP medications are purchased at or below 340B prices by the Department of State Health Services. Pharmacies are not entitled to file for 340B rebates for medications they did not purchase, including THMP medications that they distribute, or any medications that were purchased at or below the 340B ceiling price.
If guest chooses to not get medication (i.e.: dosage change, adverse effects, side effects, other plan coverage, moves to another area, passes away, etc.) whom do we contact to return the inventory?
The pharmacy should contact the THMP order processing staff to arrange for inventory return and have a call tag issued for pickup, if applicable. It’s also possible to arrange for the transfer of unopened medications from one THMP client to another, but any such transfer must be pre-approved by THMP order processing staff – please call for details.
The lot number and expiration date must be legible on returned medications. If it is not, the medication cannot be verified as being safe to use, and it will be wasted. For this reason, THMP requires either covering the manufacturer’s label with clear tape before applying the client label to the bottle, or not applying the client label until the bottle is dispensed. Please also remember to keep track of THMP-provided medications, as they must be returned to THMP if not used.
Un-dispensed medications should be returned or transferred. Please do not place THMP clients on auto-fill, as this may lead to unused medication at the pharmacy. Medications must be dispensed to the client within ten days of receipt at the pharmacy. If they cannot be dispensed, please contact THMP to return or reassign the medication.
If guest has a reaction to the medication, is there a return process to the pharmacy or state?
Please contact THMP order processing staff if such a situation arises.
If guest’s drug regimen changes during an active month’s prescription, are there exceptions for overrides for dosage changes (i.e.: daily dose increase, strength change, medication change, etc.)?
Exceptions for dosage changes do occur and are handled on a case-by-case basis by THMP order processing staff. In the case of complete regimen changes, it is preferred that clients finish their current supply of medications if that is possible. Dispensed, unused medication cannot be reassigned or otherwise used, and must be destroyed.
If product is to be dispensed in original packaging, and the guest wants non-child resistant packaging and the package does not support that, should we supply an additional labeled vial for guest to transfer? Or if the packaging allows exchanging the child-resistant cap for a non-safety cap, are we allowed to alter the bottle since it would change the "original container"?
Either solution would be acceptable. The full quantity must still be dispensed, however.
Are there issues with quality standards as relates to potential recall notification (i.e.: wholesalers supply us with lot numbers they shipped us, does the department handle that and who is responsible for proper notification)?
In the event that DSHS Pharmacy staff is made aware of such a recall by either our wholesaler or the manufacturers, efforts will be made to contact our participating pharmacies.
Are there agreements set up for proper storage of medications before they are delivered to us to ensure full potency of the drugs dispensed? If not, who is held liable in the event there is an issue?
Our wholesaler ships medications weekly to the DSHS Pharmacy warehouse, who in turn take the necessary precautions for proper storage and handling of medications. Once the medications are shipped out to participating pharmacies, should any specific issues arise with the quality of medications received that pharmacy would contact the THMP with the details and a determination will be made as to how to proceed.
Is there an attempt to always ship the same manufacturer each month, specifically concerning generic medications? Is there a list of the current manufacturers and NDC numbers used to update our drug records?
Most of the medications provided on the THMP formulary are antiretroviral medications that have a single source brand manufacturer with no generic equivalent. For those generic drugs that are available on the THMP formulary, no guarantee can be made as to which item will be shipped because we must purchase the least expensive version available at the time an inventory order is placed with our wholesaler. The THMP purchases medications using the Public Health Service 340B discount pricing.
For the guest to receive the medication on a monthly basis, are there requirements that the prescription needs to be issued a new prescription number (i.e.: do we need to contact the doctor each time the medication is needed or are refills allowed to be on the original prescription?)?
THMP expects the physicians and pharmacists to set appropriate refill requirements for individuals, following Federally-Approved Clinical Practice Guidelines for HIV/AIDS.
Does the prescription have to be hand-written by the physician or are telephoned, faxed, or electronic prescriptions allowed (if allowed by law) for the plan to cover the medication?
We adhere to Texas State Board of Pharmacy guidelines, so as long as the situation would allow for telephoned, faxed, or electronic prescriptions its fine with us as well.
Is there notification given to the pharmacy in the event the guest is no longer eligible to receive medications through one of our pharmacies? Does this follow under the six month of inactivity section?
The typical situation would be where a client is dropped after six months of inactivity, but there may also be situations where a client’s change in income, insurance coverage for prescriptions or Texas residency status makes them ineligible for coverage. Order approvals and denials are faxed back to the pharmacy upon completion. Denials will have a reason listed.
Are the day supply limits monitored by the program or is the guest able to receive the medication early for particular reasons (i.e.: need to go out of town, transportation issues, etc.)?
The THMP does monitor supply limits and special requests. The client would need to fax the THMP a written request for an early order or up to a three-month supply prior to that order, with the following information: their name, THMP ID#, what they are requesting (2 or 3 months’ supply at the normal time, or a single month early refill), the reason for exception, and the dates of travel if applicable. A maximum of three months’ worth of medication may be dispensed on a case-by-case basis. A form is available on the THMP website for the client or their representative to fill out in this situation.
For medication that is lost or stolen once it is dispensed to the guest, who is responsible for reporting the loss, the pharmacy, or the guest? What documentation is necessary (i.e.: police report, etc.)?
The client should notify the pharmacy when such a situation arises and then fax a written replacement request to the THMP detailing the circumstances. A copy of the police report would also be helpful for our records if applicable. Replacement requests are monitored and approved on a case-by-case basis by the THMP.
Delivery to the client is at the pharmacy’s discretion, although THMP does not recommend doing so. If the medication is mailed by the pharmacy to the client, but is lost or destroyed en route, the pharmacy is responsible for the replacement. Pharmacies must not mail medications out of state. Further exceptions may be made during declared disasters on a case-by-case basis.
If guest is unable to pay their portion of the medication(s), does the state reimburse the pharmacy for the lost money? If yes, how is this reported and at what frequency should it be requested?
The THMP rules regarding copayments have changed. If your pharmacy has signed the 2017 or later Memorandum of Agreement, you will no longer charge the guest a dispensing fee for THMP medications. The pharmacy should instead keep track of the dispensed medications and invoice THMP monthly using the forms provided when the Memorandum of Agreement is finalized. This applies to Medicaid-eligible and non-eligible clients.
If your pharmacy has not yet renewed the Memorandum of Agreement, please contact THMP about signing the current Memorandum of Agreement as soon as possible.
What is the anticipated time frame for shipment of the drugs to the pharmacy? Are there end of week shipments or do they only ship on certain days of the week?
The DSHS Pharmacy warehouse ships drugs to the participating pharmacy on every weekday, so most orders will arrive in 2-3 business days from the time an order is initially placed. Non-refrigerated items are shipped Monday through Friday, while refrigerated items are placed in a “cold pack” and sent Monday through Thursday.
At what frequency is the pharmacy list updated?
Updates occur as new pharmacies are added ,or former pharmacies are discontinued. The website will list the latest update date.
Are pharmacies notified directly if there are changes in the program or is information maintained on the website only?
Changes that affect the pharmacies will be sent directly to the pharmacies via fax or mail in addition to being posted on the THMP website and email list. Pharmacies are encouraged to sign up to the THMP News email list.
What should we do if the pharmacy is temporarily or permanently closed for an unforeseen reason (i.e., a hurricane)?
Notify THMP as soon as possible, so that we can make arrangements for our clients to choose another pharmacy. Once you can re-open, call THMP so that the hold on your pharmacy can be removed. If there were THMP medications at your pharmacy awaiting pickup, those medications will need to be returned to THMP, and if damaged, THMP will arrange for their destruction.
What should we do if we find out that a client has Medicare or insurance?
Notify the program as soon as possible. These clients can then be contacted to enroll in the State Pharmacy Assistance Program (SPAP) if they have Medicare, or in the Texas Insurance Assistance Program (TIAP) if they have insurance. SPAP and TIAP are wrap-around programs that assist with the recipients’ copays.