2703. REIMBURSEMENT FOR PRESCRIPTIONS

2703 REIMBURSEMENT FOR PRESCRIPTIONS 2703.1 The District of Columbia Medicaid Program shall reimburse claims submitted by participating providers for the following prescriptions: Legend drugs that are approved for safety and effectiveness as prescription drugs by the U.S. Food and Drug Administration (“FDA”) and prescribed for their FDA-approved indication; Over-the-counter (“OTC”) medications as listed in the District Medicaid Preferred Drug List and the Pharmacy Billing Manual. The following categories of OTC medications shall be covered when prescribed by a licensed provider: (1) Oral Analgesics with a single active ingredient (e.g., aspirin, acetaminophen, and ibuprofen); (2) Ferrous salts (sulfate, gluconate); (3) Antacids (aluminum, magnesium, bismuth); (4) Diabetic preparations (e.g., Insulin); (5) Single agent Vitamin Bl, Vitamin B6, Vitamin Bl2, Vitamin D, folic acid products, and geriatric vitamins; (6) Family planning drugs; (7) Senna extract; (8) Smoking cessation products; (9) Single ingredient antihistamine medications; (10) Single ingredient cough and cold medications; and (11) Select agents when used for anorexia, weight loss, or weight gain as indicated in the District Medicaid Preferred Drug List and the Pharmacy Billing Manual; (c) Prenatal vitamins and fluoride preparations, as required under Section 1927 of the Social Security Act; (d) Diabetic preparations (e.g., blood glucose monitors, blood glucose test strips, syringes), when prescribed by a licensed provider; and (e) Other drugs or products used for mitigating disease in the event of a public health emergency. SOURCE: Final Rulemaking published at 59 DCR 2298, 2300 (March 23, 2012); as amended by Final Rulemaking published at 65 DCR 7837 (July 27, 2018). District of Columbia Municipal Regulations Public Welfare 29 DCMR § 2703