Texas Association of Community Based Health Plans Partnership with Navitus Health Solutions Provides Pharmacy Benefits to 1.3 Million Medicaid Members

Lindsay, Stone & BriggsKailey BenderOffice: (608) 251-7070

Navitus Health Solutions, LLC, a national, full pass-through pharmacy benefit manager (PBM), announces the successful implementation of a PBM program for the Texas Association of Community Based Health Plans (TACHP), a group of managed Medicaid and CHIP plans in Texas. This partnership began in March 2012 and is under a 5-year contract. Comprised of the following health plans under the Navitus pharmacy benefit, TACHP supports more than 1.3 million Medicaid members in Texas:

The TACHP confirmed that the implementation and first seven months of pharmacy benefit services have been extremely well-executed for the health plans and plan participants.

“Driscoll’s carve-in of pharmacy benefit services with Navitus has gone remarkably well. I continue to hear praise from the other health plans in Texas that Navitus is the best PBM they’ve worked with,” said Mary Dale Peterson, MD, CEO of Driscoll Children’s Health Plan. “Navitus has made a commitment to Driscoll and the Texas plans by opening an office in Texas, attending TACHP meetings in person, and addressing the needs of the individual health plans.”

Navitus provides the TACHP a full suite of PBM services, including claims adjudication, pharmacy network management, clinical programs/consultation, analytical support, and mail and specialty pharmacy programs. In addition, Navitus opened a fully-staffed Customer Care and Clinical and Account Management office in Austin, Texas, to serve the TACHP and its plan participants. The Austin office includes a dedicated team with extensive Medicaid experience to address the TACHP health plans’ strategic service delivery and regulatory needs.

The TACHP health plans are benefiting from Navitus’ unique business model, which offers cost-savings opportunities with 100 percent pass-through pricing, including high-touch clinical and client services and operational excellence.

“The implementation of the Association’s pharmacy benefit programs was highly collaborative. Navitus worked collectively with the Texas Association of Community Based Health Plans and separately with each member health plan to successfully implement the Texas Medicaid pharmacy carve-in program,” said Dennis Edmonds, President & CEO of TACHP. “One key to success was identifying business and clinical leads within each health plan and assigning Navitus implementation teams to each health plan to form working partnerships at the local level.”

“Working with the TACHP health plans to implement their programs has been very rewarding, and we look forward to a successful future of collaboration and partnership,” said Terry Seligman, President & CEO of Navitus.

On October 25 at 3:30 p.m., Dennis Edmonds will be presenting with Navitus at the Medicaid Health Plans of America (MHPA) Annual Meeting. The presentation, titled , will detail the TACHP and Navitus collaborative partnership. Edmonds also will be presenting with Navitus at an October 10 Webinar hosted by the Association for Community Affiliated Plans (ACAP) for its members.

The Texas Association of Community Based Health Plans joined together in 2012 to manage pharmacy benefits for more than 1.3 million Medicaid and CHIP members among nine health plans in Texas. The health plans service members in the following areas in Texas: Austin, Beaumont/Port Arthur, Corpus Christi, Dallas, El Paso, Fort Worth, Houston, Lubbock, McAllen and San Antonio.

Navitus Health Solutions, LLC is a full service, URAC-accredited pharmacy benefit management company. As a zero-spread, full pass through pharmacy benefit manager (PBM), Navitus aligns performance with plan sponsors’ benefit goals to deliver comprehensive clinical programs and cost-saving strategies that lower drug trend and promote better member health. Navitus provides its flexible services to health plans, including managed Medicaid and Medicare Part D, government entities, self-funded employers, coalitions, labor organizations and third-party administrators. For more information about Navitus Health Solutions’ real solutions to the rising cost of prescription drugs in health care, visit or call 877-571-7500.