In July 2012 the state of Illinois passed new measures designed to reduce Medicaid pharmacy spending by capping monthly prescriptions to four per month for most medication classes and requiring copayments for medications. These measures are part of the "Save Medicaid Access and Resources Together Act" (SMART Act), which included $1.6 billion in spending reductions, utilization controls, and provider rate cuts. As part of SMART, prescriptions for both adult and children were limited to four prescriptions per month, with additional prescriptions available based on patients’ needs. The purpose of the four-prescription limit is to have . . .