PURPOSE: This rule establishes a listing of excluded drugs or categories for which reimbursement is not available through the Missouri Medicaid Pharmacy Program.

1. (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. (2) List of drugs or classes which are excluded from reimbursement through the Missouri Medicaid Pharmacy Program— Exceptions— Drug or Category Reimbursable Drugs used to promote fertility Drugs used to promote weight loss Drugs used to promote hair growth Drugs used for cosmetic purposes Nonlegend vitamins, multivitamins and minerals, Children’s adult Chewable Multivitamins Calcium Preparations Iron Preparations Drugs used to promote smoking cessation Nonlegend lotions, shampoos and medicated soaps Nonlegend acne preparations Nonlegend weight control products Nonlegend ophthalmic products Artificial tear products Eyewash products Ocular lubricants Contact lens products Nonlegend oral analgesics All nonlegend strengths and dosage forms of: Acetaminophen Aspirin Buffered aspirin Ibuprofen Naproxensodium Nonlegend stimulant products Nonlegend external analgesic products

   (1/29/01)* MATT BLUNT Exceptions—

   Drug or Category Reimbursable

Nonlegend hemorrhoidal products Halazepam Prazepam Estazolam Quazepam AUTHORITY: sections 208.153 and 208.201, RSMo 1994.* Original rule filed Dec. 13, 1991, effective Aug. 6, 1992. Amended: Filed June 30, 2000, effective Feb. 28, 2001. *Original authority: 208.153, RSMo 1967, amended 1973, 1989, 1990, 1991 and 208.201, RSMo 1987.