Nebraska Administrative Code
Topic - HEALTH AND HUMAN SERVICES SYSTEM
Title 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES
Chapter 16 - PHARMACY SERVICES
Section 471-16-014 - UTILIZATION

Universal Citation: 471 NE Admin Rules and Regs ch 16 ยง 014

Current through September 17, 2024

Since it is the pharmacist's professional responsibility to ascertain drugs are being utilized according to the prescriber's directions and no abuse or overuse exists, the Department will not reimburse pharmacists for prescriptions which demonstrate a lack of this professional obligation. Providers are required to maintain patient record systems or other adequate records to prevent these errors in dispensing. The Department's professional staff is responsible for determining whether a claim violates the Department's regulations. The Nebraska Point of Purchase system will identify drug claims when potential overuse exists, and these claims will be denied

014.01 TOBACCO CESSATION. Medicaid covers tobacco cessation services as practitioner and pharmacy services under the following conditions:

(A) Tobacco cessation counseling visits with an enrolled medical provider or pharmacist tobacco cessation counselor may be a combination of intermediate or intensive tobacco cessation counseling visits;

(B) Tobacco cessation products are covered by Medicaid as a pharmacy service for those clients meeting Federal Food and Drug Administration approved dosing and age guidelines who require this particular assistance. Tobacco cessation counseling provided by a Tobacco Cessation counselor must be ordered by the physician or mid-level practitioner: and

(C) Nebraska Tobacco Free Quitline: In conjunction with tobacco cessation products, recipients are encouraged to be enrolled in and active with the Nebraska Tobacco Free Quitline. Referral to the Quitline may be made by a medical professional or a self-referral. Recipient access to the Nebraska Tobacco Free Quitiine is unlimited.

Disclaimer: These regulations may not be the most recent version. Nebraska may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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