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Effective Date: 
5/2021

Documents

 

Instructions

Updated: 5/2021

 

Purpose

Texas Health and Human Services issued the Texas Medicaid Standing Order for Mosquito Repellent for use by people enrolled in Medicaid, Children’s Health Insurance Program and Healthy Texas Women Program. The order serves as a prescription and allows pharmacists to dispense mosquito repellent under the terms of the order. Pharmacies are encouraged to use this order instead of contacting the health care provider for an individual prescription for mosquito repellent. Texas HHS requires a prescription from a valid health care provider for any pharmacy or pharmacist not operating under the standing order.

Detailed Instructions

Request a copy of the Texas Medicaid Standing Order for Mosquito Repellent by emailing the Vendor Drug Program at vdp-formulary@hhsc.state.tx.us. The pharmacy staff retains HHS Form 1404 in their records.

Questions

Refer comments or questions about this form to the Vendor Drug Program at vdp-formulary@hhsc.state.tx.us.