4 Prescription Limit for Medicaid Update

October 30, 2012

Dear Member:

As many of you have heard, The SMART Act revised several components of the Illinois Medicaid Code and one change involved requiring patients with more than 4 prescriptions in a 30-day period to obtain prior authorization before they can receive them.  This has caused much anxiety for patients but it appears that most situations are being handled in a relatively timely fashion.  The Illinois Department of Healthcare and Family Services has issued an update on the progress toward implementation. 

This document can be found on the ICHP website: http://www.ichpnet.org/resources/uploads/pdfs/Medicaid_Limit_4_update_10-30-12.pdf.  The document will be helpful when discussing Medicaid patients’ medication needs and may also help you and your colleagues as you serve this population.

We hope this document is helpful and encourage each of you to stay informed on all the changes within the SMART Act.

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