Mo. Code Regs. Ann. tit. 13, § 70-20.032
List of Drugs Excluded From Coverage Under the Missouri Medicaid Pharmacy Program
Effective Jan 30, 2003sections 208.153 and 208.201, RSMo 2000.* Original rule filed Dec. 13, 1991, effective Aug. 6, 1992. Amended: Filed June 30, 2000, effective Feb. 28, 2001. Emergency amendment filed June 7, 2002, effective July 1, 2002, expired Dec. 27, 2002. Amended: Filed June 11, 2002, effective Jan. 30, 2003. *Original authority: 208.153, RSMo 1967, amended 1973, 1989, 1990, 1991 and 208.201, RSMo 1987Mo Healthnet Division
PURPOSE: This rule establishes a listing of excluded drugs or categories for which reimbursement is not available through the Missouri Medicaid Pharmacy Program.
- (1) Permissible Exclusions—As specified in the Social Security Act, Section 1927(d)(1)(B), states may exclude or otherwise restrict coverage of certain covered outpatient drugs. Section 1927(d)(2) of the Social Security Act provides a listing of the categories of drugs that are permissible for exclusion.
- (2) List of drugs or classes which are excluded from reimbursement through the Missouri Medicaid Pharmacy Program shall be made available through the Department of Social Services, Division of Medical Services website at www.dss.state.mo.us/dms, provider bulletins, and upates to the provider manual.
AUTHORITY: sections 208.153 and 208.201, RSMo 2000.* Original rule filed Dec. 13, 1991, effective Aug. 6, 1992. Amended: Filed June 30, 2000, effective Feb. 28, 2001. Emergency amendment filed June 7, 2002, effective July 1, 2002, expired Dec. 27, 2002. Amended: Filed June 11, 2002, effective Jan. 30, 2003. *Original authority: 208.153, RSMo 1967, amended 1973, 1989, 1990, 1991 and 208.201, RSMo 1987.