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Elizabeth M. Whitehorn, Director

Provider Notice issued 12/18/2023

 

To: ​ Enrolled Pharmacies
​Date: ​December 18, 2023
​Re: Over-the-Counter Birth Control

The Department of Healthcare and Family Services (HFS) continues to prepare for the release of the new over-the-counter (OTC) birth control pill, Opill, which is anticipated in early 2024. Opill will be covered by HFS under both the fee-for-service (FFS) program and managed care organizations (MCOs) without a prescription for women aged 18 years and older.

HFS requires pharmacies to submit all claims, including those for OTC medications,  with a prescriber National Provider Identifier (NPI) in the Prescriber ID field (411-DB). For Opill, pharmacies may bill using the Illinois Department of Public Health standing order prescriber NPI for hormonal contraceptives.

Questions regarding this notice may be directed to a pharmacy consultant in the Bureau of Professional and Ancillary Services at 877-782-5565 for FFS claims, or the appropriate MCO.

 

Kelly Cunningham, Administrator
Division of Medical Programs