Ill. Admin. Code tit. 89, § 119.80 - Illinois Cares Rx Basic Covered Prescription Drugs

The Illinois Cares Rx Basic Program shall cover pharmaceutical products as described in this Section for the treatment of heart disease and its related conditions, diabetes, arthritis, cancer, Alzheimer's disease, Parkinson's disease, glaucoma, lung disease and smoking related illnesses, osteoporosis and multiple sclerosis.

a) Drugs prescribed for treatment of heart disease and its related conditions that fall within the following categories qualify for inclusion in the Illinois Cares Rx Basic Pharmaceutical Assistance Program as covered prescription drugs:

1) Antihypertensives

2) Antiarrhythmics

3) Antihyperlipidemics

4) Cardiac Glycosides

5) Calcium Channel Blockers

6) Vasodilators

7) Anti-Adrenergic/Sympatholytics

8) Renin Angiotensin System Antagonists

9) Diuretics

10) Potassium Supplements

11) Anticoagulants

12) Vasopressor Used in Shock

13) Potassium Removing Agents

14) System Alkalinizers

b) Drugs that fall within the following categories for the treatment of diabetes qualify for inclusion in the Illinois Cares Rx Basic Pharmaceutical Assistance Program as covered prescription drugs:

1) Insulin

2) Syringes and Needles

3) Oral Hypoglycemics

4) Posterior Pituitary Hormones

5) Hyperglycemics

c) Drugs that fall within the following categories and are prescribed for the treatment of arthritis qualify for inclusion in the Illinois Cares Rx Basic Pharmaceutical Assistance Program as covered prescription drugs:

1) Adrenocortical Steroids

2) Antimalarials

3) Analgesics

4) Antirheumatic Agents

5) Immunomodulators

6) Immunosuppressives

7) NSAIDS

8) Penicillamine

d) Drugs that fall within the following categories and are prescribed for the treatment of cancer qualify for inclusion in the Illinois Cares Rx Basic Pharmaceutical Assistance Program as covered prescription drugs:

1) Analgesics

2) Anticonvulsants

3) Antineoplastics

4) Immunomodulators

e) Drugs that fall within the following categories and are prescribed for the treatment of Alzheimer's disease qualify for inclusion in the Illinois Cares Rx Basic Pharmaceutical Assistance Program as covered prescription drugs:

1) NMDA Receptor Antagonists

2) Cholinesterase Inhibitors

f) Drugs that fall within the following categories and are prescribed for the treatment of Parkinson's disease qualify for inclusion in the Illinois Cares Rx Basic Pharmaceutical Assistance Program as covered prescription drugs:

1) Antiparkinson Agents, Anticholinergics

2) Antiparkinson Agents, Other

3) Pituitary Suppressive Agents

g) Drugs that fall within the following categories and are prescribed for the treatment of glaucoma qualify for inclusion in the Illinois Cares Rx Basic Pharmaceutical Assistance Program as covered prescription drugs:

1) Miotics/Other Introcular Pressure Reducers

2) Mydriatics

3) Carbonic Anhydrase Inhibitors

h) Drugs that fall within the following categories and are prescribed for the treatment of lung disease and smoking related illnesses qualify for inclusion in the Illinois Cares Rx Basic Pharmaceutical Assistance Program as covered prescription drugs:

1) Bronchodilators

2) Diluents

3) Mucolytics

4) Pancreatic Enzymes

5) Smoking Cessation Products

6) Corticosteroid Respiratory Inhalants and Combinations

7) Antituberculosis Agents

8) Mast Cell Stabilizers

9) Leukotriene Receptor Antagonists

10) Leukotriene Formation Inhibitors

11) Monoclonal Antibodies

12) Respiratory Enzymes

i) Drugs that fall within the category of Bone Resorption Inhibitors and are prescribed for the treatment of osteoporosis qualify for inclusion in the Illinois Cares Rx Basic Pharmaceutical Assistance Program as covered prescription drugs.

j) Multiple Sclerosis

1) Drugs that fall within the following categories and are prescribed for the treatment of multiple sclerosis qualify for inclusion in the Illinois Cares Rx Basic Pharmaceutical Assistance Program as covered prescription drugs:

A) Immunomodulators

B) Immunosuppresives

C) Adrenocortical Steroids

D) Urinary Tract Anti-Spasmodic/Anti-Incontinence Agents,

E) Antibiotics Used in the Treatment of Urinary Tract Infections

F) Antidepressants

G) Urinary Tract Anesthetic/Analgesic Agents

H) Stimulants

I) The following Skeletal Muscle Relaxants: baclofen, dantrolene, tizanidine

2) Coverage of Urinary Tract Anti-Spasmodic/Anti-Incontinence Agents, Antibiotics, Antidepressants, Urinary Tract Anesthetic/Analgesic Agents and Stimulants may be limited to generic agents when appropriate generic agents are available.

k) An Illinois Cares Rx Basic covered prescription drug must be approved by the Food and Drug Administration of the federal Department of Health and Human Services for the treatment of a specific disease category.

Notes

Ill. Admin. Code tit. 89, § 119.80

Amended at 34 Ill. Reg. 6788, effective May 1, 2010