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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 of Contraceptive Drugs or Supplies and Emergency Contraceptives

 

 

This notice is a reminder regarding the dispensing quantity for contraceptive drugs or supplies and emergency contraceptives. This information applies to participants covered under traditional Medicaid fee-for-service, as well as those enrolled in a HealthChoice Illinois managed care plan.

 

Providers must dispense the three-month supply of contraceptive drugs or supplies allowable by the Department whenever possible. Exceptions may be made when medically contraindicated and documented in the patient’s chart, or if patient and provider decision making does not require a three-month supply to be dispensed. Providers should ensure medical records document the reason for not dispensing the required three-month supply.

 

Providers are also reminded of the dispensing policy for emergency contraceptive pills (ECPs), which allows for advance provision of up to three doses, including over the counter (OTC) emergency contraceptive drugs or supplies with a prescription. In most cases, providing patients with sufficient supply increases adherence to the method. Clinical guidelines encourage timely provision and patients should also be counseled on a more effective form of birth control at the time ECPs are provided.

 

Questions regarding this notice may be directed to the Bureau of Professional and Ancillary Services at 877-782-5565 for fee-for-service claims, or to the applicable managed care plan. 

 

 

 

Kelly Cunningham, Administrator

Division of Medical Programs​


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JB Pritzker, Governor • Theresa Eagleson, Director