Effective June 1, 2006, a new pharmacy prescription limit was implemented raising the prescription limit to 8 prescriptions per month. At the discretion of the pharmacist, the monthly prescription limit may be overridden with three (3) additional prescriptions per recipient per month. Recipients under the age of 21 or residents of intermediate care facilities/mental retardation centers and nursing facilities are exempt from the 8 prescription limit and the Prescription Management Program. CAP recipients are no longer exempt.
In addition, it is no longer necessary for the pharmacist to remove the pharmacy stub in order to receive payment for filled prescriptions. Since the pharmacy stub is not necessary, Medicaid recipients are no longer required to go to the same pharmacy for the entire month unless they receive more than 11 prescriptions per month and participate in the Prescription Management Program.
MA-2380, Medicaid Identification Card, is updated with the new prescription limit information and the instructions for completing a county issued Medicaid card have been updated to include the family planning waiver information on the card.
This policy is effective 10-01-06. Apply this policy to all ongoing cases and cases approved on or after 10-01-06.
DMA Change Notice No. 20-06
REMOVE: MA-2380, Medicaid Identification Card, pages 1-9.
Insert: MA-2380, Medicaid Identification Card, pages 1-10.
If you have questions, please contact your Medicaid Program Representative.
L. Allen Dobson, JR., M.D., Assistant Secretary for Health Policy and Medical Assistance
[This material was researched and prepared by Trenita Dawkins, Policy Consultant, Medicaid Eligibility Unit]
For questions or clarification on any of the policy contained in these manuals, please contact your local county office.