Illinois Medicaid Four Scrip Monthly Limit Memo

September 4, 2012
The purpose of the four-prescription limit is to have providers review their patients’ maintenance medications and, where possible and clinically appropriate, reduce duplication, unnecessary medications, and polypharmacy. The department will allow clients to exceed four prescriptions per month in certain situations, with prior approval. If the drug is not on the approvable drug list, the drug will not be allowed as an exception to the four- prescription limit. This list is independent of the Preferred Drug List (PDL) and other criteria. The following classes of medication are exempt from the monthly prescription cap: oncolytics, anti-retroviral . . .