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.

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