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Cook Children's Health Plan

Pharmacy Information

Medical Supplies

Cook Children's Health Plan uses Navitus Health Solutions as their Pharmacy Benefit Manager (PBM).

Please visit the Navitus website for the following pharmacy information:

Navitus Provider Relations can assist you with:

  • Network participation
  • Network access reports
  • Contract questions
  • Pharmacy credential review
  • Reimbursement and remittances
  • Maximum allowable cost list (MAC)
  • Network system set up
  • Pharmacy performance analysis and reporting
  • Pharmacy communications

Providers can contact Navitus at:

Visit the Texas Medicaid/CHIP Vendor Drug Program to view the:

The Texas Medicaid formulary is updated regularly by the Texas Vendor Drug Program located on txvendordrug.com.

Clinician Administered Drugs

Medicaid Services Program may reimburse providers only for Clinician-administered drugs and biologicals whose manufacturers participate in the Centers for Medicare and Medicaid Services (CMS) Drug Rebate Program and that show as active on the CMS list for the date of service the drug is administered. Clinician-administered drugs that do not have a rebate-eligible National Drug Code (NDC) will not be reimbursed by Texas Medicaid Program. Please note there may be ingredients in a compound that are not considered a drug under the Federal Food, Drug, and Cosmetic Act.