Illinois Administrative Code
Title 89 - SOCIAL SERVICES
Part 140 - MEDICAL PAYMENT
Subpart D - PAYMENT FOR NON-INSTITUTIONAL SERVICES
Section 140.449 - Payment of Pharmacy Items
Current through Register Vol. 48, No. 38, September 20, 2024
a) The Department shall pay no more for charges submitted than the maximum permitted by federal regulations.
b) Explanation of Drug Restrictions
Acetaminophen Drops 80mg/0.8ml
Acetaminophen Drops 120mg/2.5ml
Acetaminophen Elixir/Syrup 120mg/5ml
Acetaminophen Tab/Cap 325mg
Acetaminophen Tab/Cap 500mg
Acetaminophen Tab/Cap 650mg
Acetaminophen Tablet Chewable 80mg
Acetaminophen Tablet Chewable 120mg
Aspirin Tab Buffered 325mg
Aspirin Tab Buffered 600mg
Aspirin Tab EC 300mg
Aspirin Tab EC 600mg
Aspirin Tab Pediatric
Aspirin Tab 300mg
Aspirin Tab 600mg
Glucola Liquid
Milk of Magnesia Liquid
Milk of Magnesia Tablet
Zinc Oxide Ointment
c) No restrictions - The drug is available to all recipient categories, including nursing home residents and recipients of basic health coverage.
d) Group Care Restricted - The drug is available to all recipients except recipients residing in nursing homes. The nursing home must provide the following listed items to resident recipients at no charge to the recipient:
Acetest Reagent Tablets
Albustix Strips
Chemstrip BG Strips
Chemstrip GP Chemstrip K Papers
Chemstrip Test Kit
Chemstrip UG Strips
Chemstrip UGK Strips
Chemstrip 5
Clinistix Strip
Clinitest (2 Drop)
Clinitest Analysis Set
Clinitest Analysis Set (2 Drop)
Clinitest Tablet
Clinitest Tablet Foil
Combistix
Dextrostix Reagent Strips
Dextrostix Reagent Strips Foil
Diascan Dual Pad Strips
Diastix Strips
Exactech Test Strips
Glucofilm Test Strips
Glucoscan Test Strips
Glucostix Strips
Hema-Combistix
Hemastix Strips
Hematest Tablet
Keto-Diastix
Keto-Diastix 5
Ketostix Strips
Labstix
Lancet for Diabetic Use, Sterile
N-Uristix
One Touch Test Strips
TES-Tape
Tracer BG Strips
Trendstrips
Uristix
Visidex II Reagent Strips
Any product equivalent to those on the above list or any other nonlisted diabetic testing supply
e) Group care limited - The drug is available only to recipients residing in nursing homes.