016.06.02 Ark. Code R. § 010 - Pharmacy Update Transmittal #57
Prescriptions for Medicaid-eligible LTC facility residents are not subject to a monthly prescription limit, however, the drug product must be covered under the Arkansas Medicaid Pharmacy Program. (Refer to section 210.000 for program coverage, section 212 for exclusions and section 252 for reimbursement to LTC facilities.)
Medicaid recipients who have elected to receive hospice services in LTC facilities may only use their prescription drug benefits to treat conditions not directly related to their terminal illness. These recipients are only allowed three (3) prescriptions per month. If additional prescriptions are needed, an extension of drug benefits may be requested for up to a total of six (6) maintenance medications per month. Drugs related to the terminal illness must be furnished by the hospice.
Only oral solid medications may be cycle-filled. However, if an oral solid medication meets one of the categories below, then that oral solid medication may not be cycle-filled.
When a facility notifies a pharmacy in writing of any change of condition that affects the medication status of a resident, the pharmacy shall immediately amend the filling of the prescription to conform to the changed medication requirement of the resident.
For purposes of this section, change of condition includes death, discharge or transfer of a resident, as well as medical changes of condition that necessitate a change to the medication prescribed or the dosage given.
Generally, there are two (2) types of drug distribution systems used in long-term care facilities. They are the traditional packaging system and unit dose system. The Pharmacy Program does not utilize a different dispensing fee to calculate reimbursement for various types of drug distribution systems.
Pharmacy providers for long-term care facilities must supply 24-hour service to their patients regardless of the drug distribution system used.
RESERVED
Arkansas Medicaid Manual: PHARMACY
Subject: PROGRAM COVERAGE
Effective Date: 2-15-81
Revised Date:3-1-02
RESERVED
Arkansas Medicaid Manual: PHARMACY
Subject: PROGRAM COVERAGE
Effective Date: 9-1-01
Revised Date: 3-1-02
RESERVED
Notes
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