Friday, February 1, 2013

ALERT: Illinois Medicaid Prescription Change on MONDAY February 4. 2013

As posted by Access Living
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Dear Access Living friends and allies,

One of the challenges presented to Medicaid consumers through the SMART Act last spring is the reduction of the number of prescriptions that can be filled without prior authorization. The target number of prescriptions was set at four. The state has been operating at a limit of 7 for some time and yesterday, we found out that as of MONDAY February 4, the limit is set at FIVE prescriptions.

Here is a statement from Illinois Health and Family Services:
Effective February 4, 2013, the department will reduce the number of prescriptions that can be filled in a thirty-day period without prior authorization from seven to five. In addition, the department will begin to phase-in prescriptions for patients residing in long-term care facilities (LTC), including participants residing in community-based long-term care settings
Here are links to the notices sent to providers and pharmacies:

Long Term Care Provider Notices page – http://www.hfs.illinois.gov/ltc/

Pharmacies Provider Notices page – http://www.hfs.illinois.gov/pharmacies/

Please alert Medicaid consumers to this change

The change is the result of efforts to reduce waste in the Medicaid system by making sure prescriptions are properly authorized, but of course the flip side is that there are many Medicaid consumers who rely on more than four, more than five, more than seven prescriptions year in and year out, and requiring pre-authorization could create undue burdens for many. Advocates are hard at work fighting for a system that will work for everyone, but in the meantime do please make sure Medicaid consumers you know are aware of this change.

Amber Smock
Director of Advocacy, Access Living
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For Access Living : http://www.accessliving.org/

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