PURPOSE: This rule imposes a limitation on the number of prescriptions which may be covered services within a specified time period for each recipient.

1. (1) The number of prescriptions which may be filled or refilled will be limited to five (5) per recipient during any one (1) period of eligibility which does not exceed the normal monthly eligibility span for the recipient’s assistance category involved.

   1. (A) The only allowable exception to the five (5)-prescription limitation will be for certain specified drugs which are commonly prescribed for long-term chronic medical conditions and for prior authorized drugs.
   2. (B) These listed drugs shall be considered to be used for the treatment of long-term chronic medical conditions and shall therefore be exempted from the prescription limitation. Acebutolol HCl Acetazolamide Acetohexamide Albuterol Albuterol Sustained Release Tablets Amantadine HCl Amiloride HCl and Hydrochlorothiazide Tablets Amiloride HCl Tablets Aminophylline Anhydrous Calcium Iodide and Isoproternal Sulfate Syrup Atenolol and Chlorthalidone Tablets Atenolol Tablets Beclomethasone Dipropionate Bendroflumethiazide Bendroflumethiazide and Nadolol Tablets Benztropine Mesylate Betaxolol HCl Ophthalmic Solution Bethanechol Chloride Biperiden Tablets Bitolterol Mesylate Bumetanide Tablets Captopril and Hydrochlorothiazide Tablets Captopril Tablets Carbachol Ophthalmic Solution Carbamazepine Carbidopa and Levodopa Chlorothiazide Chlorpropamide Tablets Chlorthalidone and Clonidine HCl Chlorthalidone Tablets Cholestyramine Clofibrate Clonazepam Clonidine HCl Clonidine Transdermal Systems Codeine Phosphate, Ephedrine Sulfate and Guaifenesin Syrup Colestipol HCl Cromolyn Sodium Demecarium Bromide Ophthalmic Solution Deserpidine and Methyclothiazide Dexamethasone Sodium Phosphate Nasal Inhaler Dexamethasone Sodium Phosphate Oral Inhaler Dichlorphenamide Tablets Dicumarol Tablets Diflunisal Digitalis Digitoxin Tablets Digoxin Diltiazem HCl Diltiazem HCl Sustained Release Capsules Dipivefrin HCl Ophthalmic Solution Dipyridamole Disopyramide Disopyramide Sustained Release Capsules Dyphylline Dyphylline and Guaifenesin Echothiophate Iodide Ophthalmic Solution Enalapril Maleate Enalapril Maleate and Hydrochlorothiazide Encainide HCl Ephedrine Sulfate Capsules Ephedrine Sulfate Syrup Ephedrine Sulfate and Guaifenesin Epinephrine Ophthalmic Solution Ergoloid Mesylates Sublingual Ethacrynic Acid Ethosuximide Flecainide Flunisolide Nasal Spray Flunisolide Oral Inhaler Furosemide Gemfibrozil Glipizide Glyburide Guaifenesin and Oxtriphylline Tablets Guaifenesin and Phenylpropanolamine HCl Sustained Release Tablets Guaifenesin and Theophylline Sodium Glycinate Tablets Guaifenesin and Pseudoephedrine HCl Sustained Release Tablets Guaifenesin and Theophylline Capsules Guaifenesin and Theophylline Tablets Guanabenz Acetate Tablets Guanadrel Sulfate Tablets Guanethidine Monosulfate and Hydrochlorothiazide Tablets Guanethidine Monosulfate Tablets Guanfacine HCl Hydralazine Hydralazine and Hydrochlorothiazide Hydralazine, Hydrochlorothiazide and Reserpine Hydrochlorothiazide and Lisinopril Hydrochlorothiazide and Methyldopa Tablets Hydrochlorothiazide and Metoprolol Tartrate Hydrochlorothiazide and Spironolactone Tablets Hydrochlorothiazide and Timolol Hydrochlorothiazide and Triamterene Hydrochlorothiazide Tablets Hydrochlorothiazide with Labetalol Hydroflumethiazide and Reserpine Indapamide Tablets Indomethacin Suppositories Insulin Intravenous Fluids Dextrose 25%, Sodium Chloride 0.45% Dextrose 5% Dextrose 5%, Lactated Ringer’s Dextrose 5%, Sodium Chloride 0.225% Dextrose 5%, Sodium Chloride 0.3% Dextrose 5%, Sodium Chloride 0.45% Dextrose 5%, Sodium Chloride 0.9% Lactated Ringer’s Sodium Chloride 0.45% Sodium Chloride 0.9% Ipatropium Bromide Isoetharine HCl Isoflurophate Ophthalmic Isoproterenol Isoproterenol and Phenylephrine Bitartrate Oral Inhaler Isosorbide Dinitrate Labetalol Levobunolol HCl Ophthalmic Solution Levodopa Levothyroxine Sodium Lisinopril Lovastatin Mecamylamine HCl Metaproterenol Sulfate Methazolamide Tablets Methyclothiazide Methyldopa Metolazone Metoprolol Tartrate Metyrosine Mexiletine HCl Nadolol Tablets Niacin Tablets Nicardipine HCl Nifedipine Capsules Nifedipine Controlled Release Tablets Nitroglycerin Spray Nitroglycerin Sublingual Tablets Nitroglycerin Sustained Release Capsules Nitroglycerin Topical Ointment Nitroglycerin Transdermal Systems Oxtriphylline Papaverine HCl Sustained Release 150 mg. Pentoxifylline Phenobarbital Phenytoin Pilocarpine HCl Ophthalmic Solution Pindolol Pirbuterol Acetate Polythiazide Potassium Chloride Capsules Potassium Chloride 10% Liquid Potassium Chloride 20% Liquid Potassium Chloride Oral Tablets Potassium Chloride Sustained Release Capsules Potassium Chloride Sustained Release Tablets Prazosin HCl Primidone Probucol Procainamide HCl Capsules Procyclidine Propranolol HCl Sustained Release Capsules Propranolol HCl Tablets Propylthiouracil Quinethazone Tablets Quinidine Sulfate Tablets Rauwolfia Serpentina Tablets Reserpine and Trichlormethiazide Reserpine Tablets Spironolactone Syringes, Disposable, Insulin Terazosin HCl Terbutaline Sulfate Theophylline Theophylline Sustained Release Capsules Theophylline Sustained Release Tablets Thyroid Tablets Timolol Maleate Tocainide Tolazamide Tablets Tolbutamide Triamcinolone Acetonide Oral Inhaler Trichlormethiazide Trihexyphenidyl Valproic Acid Valproic Acid, E.C. Verapamil HCl Verapamil HCl Sustained Release Tablets Warfarin Sodium Tablets

AUTHORITY: sections 208.153, RSMo Supp. 1991 and 208.201, RSMo Supp. 1987.* This rule was previously filed as 13 CSR 40- 81.012. Emergency rule filed Oct. 21, 1981, effective Nov. 1, 1981, expired Feb. 10, 1982. Original rule filed Oct. 21, 1981, effective Feb. 11, 1982. Amended: Filed March 14, 1984, effective June 11, 1984. Amended: Filed June 12, 1984, effective Sept. 14, 1984. Amended: Filed Jan. 15, 1985, effective April 11, 1985. Amended: Filed April 16, 1985, effective July 11, 1985. Amended: Filed Oct. 2, 1985, effective Jan. 1, 1986. Amended: Filed April 16, 1986, effective July 1, 1986. Emergency amendment filed Dec. 18, 1986, effective Jan. 1, 1987, expired Feb. 11, 1987. Amended: Filed Sept. 17, 1986, effective Dec. 1, 1986. Amended: Filed Nov. 14, 1986, effective Feb. 12, 1987. Amended: Filed Feb. 18, 1987, effective May 1, 1987. Emergency amendment filed Dec. 18, 1986, effective Jan. 1, 1987, expired Feb. 11, 1987. Amended: Filed April 17, 1987, effective July 1, 1987. Amended: Filed June 16, 1987, effective Sept. 1, 1987. Amended: Filed Aug. 18, 1987, effective Nov. 12, 1987. Amended: Filed Dec. 1, 1987, effective Feb. 11, 1988. Amended: Filed April 15, 1988, effective July 1, 1988. Amended: Filed July 15, 1988, effective Oct. 13, 1988. Amended: Filed July 15, 1988, effective Oct. 13, 1988. Amended: Filed Sept. 15, 1988, effective Dec. 11, 1988. Amended: Filed April 4, 1989, effective July 1, 1989. Amended: Filed June 6, 1989, effective Sept. 1, 1989. Amended: Filed June 30, 1989, effective Oct. 1, 1989. Amended: Filed Nov. 15, 1989, effective Feb. 1, 1990. Amended: Filed Aug. 13, 1990, effective Dec. 31, 1990. Emergency amendment filed Dec. 21, 1990, effective Jan. 1, 1991, expired April 30, 1991. Emergency amendment filed March 21, 1991, effective April 1, 1991, expired July 29, 1991. Amended: Filed March 13, 1991, effective Oct. 31, 1991. *Original authority: 208.153, RSMo 1967, amended 1973, 1989, 1990, 1991 and 208.201, RSMo 1987.