Section 29-2703. REIMBURSEMENT FOR PRESCRIPTIONS

2703.1 The District of Columbia Medicaid Program shall reimburse claims submitted by participating providers for the following prescriptions:

(a) Legend drugs that are prescribed for their labeled use; and 

(b) Over-the-counter (OTC) medications as listed in the District Medicaid Preferred Drug List and the Pharmacy Billing Manual.  The following categories of OTC medications shall be covered when prescribed by a licensed provider:

 

(1)         Oral analgesics with a single active ingredient (such as, aspirin,                    acetaminophen, and ibuprofen);

 

(2)         Ferrous salts (such as, sulfate and gluconate);

 

(3)         Antacids with up to three active ingredients (such as, aluminum,       magnesium, and bismuth)

 

(4)         Diabetic preparations (such as, insulin and syringes);

 

(5)         Pediatric, prenatal, and geriatric vitamin formulations;

 

(6)         Family planning drugs and supplies; and

 

(7)         Senna extract, single dose preparations when required for diagnostic radiological procedures performed under the supervision of a physician.

 

authority

The Director of the Department of Health Care Finance (DHCF), pursuant to the authority set forth in An Act to enable the District of Columbia to receive federal financial assistance under Title XIX of the Social Security Act for a medical assistance program, and for other purposes, approved December 27, 1967 (81 Stat. 774; D.C. Official Code § 1-307.02 (2006 Repl. & 2011 Supp.)) and section 6(6) of the Department of Health Care Finance Establishment Act of 2007, effective February 27, 2008 (D.C. Law 17-109; D.C. Official Code § 7-771.05(6) (2008 Repl.)).

source

Notice of Final Rulemaking published at 59 DCR 2298, 2301 (March 23, 2012).