Texas Medicaid Terms

Question 1

NPD

Answer 1

Non-Preferred Drug, relating to Texas Medicaid formularies. NPD medications require trial/failure of one Preferred Drug List (PDL) medication prior to coverage.

Question 2

NDC

Answer 2

National Drug Code. A series of 11 digits assigned by the FDA to a manufacturer’s drug product. The first five digits indicate the manufacturer, the next four identify the product, and the last two indicate quantity or strength of product.

Question 3

NAP

Answer 3

Non-Automated Prior Authorization. In relation to PAX auto-lookback medications for Texas Medicaid. NAP medications do not have criteria programmed into PAX, and therefore cannot be automatically reviewed for coverage through NCRx.

Question 4

MCO

Answer 4

Managed Care Organization, also known as “The Plan” for Texas Medicaid.

Question 5

HHSC

Answer 5

Health and Human Services Commission, also known as “The State”, relates to Texas Medicaid plans.

Question 6

CMS

Answer 6

Centers for Medicare and Medicaid Services, known as the “government”.