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Provider Notice Issued 02/02/2021
Date: February 2, 2021
To: Enrolled Pharmacies, Physicians,Physician Assistants, Advance Practice Nurses, Local Health Departments,School-Based Clinics, Federally Qualified Health Centers, Rural Health Centers,and Encounter Rate Clinics
Re: Reminder Regarding Dispensing ofContraceptive Drugs or Supplies and Emergency Contraceptives
Thisnotice is a reminder regarding the dispensing quantity for contraceptive drugsor supplies and emergency contraceptives. Thisinformation applies to participants covered under traditional Medicaidfee-for-service, as well as those enrolled in a HealthChoice Illinois managed care plan.
Providersmust dispense the three-month supply of contraceptive drugs or suppliesallowable by the Department whenever possible. Exceptions may be made whenmedically contraindicated and documented in the patient’s chart, or if patientand provider decision making does not require a three-month supply to bedispensed. Providers should ensure medical recordsdocument the reason for not dispensing the required three-month supply.
Providers are also reminded of the dispensing policy foremergency contraceptive pills (ECPs), which allows for advance provision of upto three doses, including over the counter (OTC) emergency contraceptive drugsor supplies with a prescription. In most cases, providing patients withsufficient supply increases adherence to the method. Clinical guidelinesencourage timely provision and patients should also be counseled on a moreeffective form of birth control at the time ECPs are provided.
Questionsregarding this notice may be directed to the Bureau of Professional andAncillary Services at 877-782-5565 for fee-for-service claims, or to theapplicable managed care plan.
KellyCunningham, Administrator
Divisionof Medical Programs