July 15, 2004
Dear Prescribing Provider:
As a convenience, cost savings and quality improvement measure, Wisconsin Medicaid is encouraging recipients to receive a 100-day supply of certain maintenance drugs. Recipients can receive a 100-day supply either directly or via mail from their pharmacy. This initiative will reduce the cost of copayments to recipients and will promote continuity in the use of maintenance drugs.
Wisconsin Medicaid, BadgerCare and SeniorCare allow a limited number of maintenance drugs to be dispensed in a 100-day supply to assure continuity of use for certain necessary medications. The following list of maintenance drugs may be dispensed in amounts up to a 100-day supply.
Maintenance Drugs Allowed in a 100-Day Supply
- Digoxin, digitoxin, and digitalis
- Hydrochlorothiazide and chlorothiazide
- Prenatal vitamins
- Fluoride
- Levothyroxine, liothyronine, and thyroid extract
- Phenobarbital
- Phenytoin
- Oral contraceptives
- Insulins
- Generic oral hypoglycemic drugs
Writing Prescription Orders
In order for pharmacy providers to dispense these maintenance drugs in a 100-day supply, prescribers must indicate on the prescription order the appropriate quantity to be given to the recipient. For example, if a prescription order is written for Phenytoin 100 mg. capsules, take one capsule three times daily, the pharmacy may dispense up to 300 capsules as long as that is the quantity indicated on the prescription order.
Prescribers are encouraged to write prescription orders for these
maintenance drugs to allow for a 100-day supply when appropriate for
the recipient. Prescribers may also be contacted by pharmacies that
dispense these maintenance drugs to Medicaid recipients. The pharmacy
may request that a recipient’s prescription order be changed to allow
for a 100-day supply.
This policy applies to Wisconsin Medicaid and BadgerCare
fee-for-service (FFS) recipients as well as SeniorCare participants.
Medicaid Managed Care Organizations (MCO) must cover all drugs covered
by FFS, but are allowed to place their own restrictions on those drugs.
Therefore, Medicaid recipients who are enrolled in an MCO may have
different day supply requirements than FFS.
Thank you for your assistance in making the Medicaid program more
cost-effective.
If you have any additional questions, please call Provider Services
at (800) 947-9627.
Sincerely,
Mark B. Moody
Administrator
MBM:my
HP05042
Wisconsin.gov |
