MedicaidPrior AuthMedium impact
Medicaid Coverage of Over-the-Counter Antihistamines Medicaid and Kidney Disease Program Step Therapy for Phosphate Binders
Maryland Medicaid·MD · Allergy & Immunology, Nephrology, Family Medicine +2 more·Pharmacy
Effective date
May 19, 2004
We identified it
Jun 20, 2026
Summary
Maryland Medicaid now covers over-the-counter (OTC) minimally sedating antihistamines as preferred drugs, while legend antihistamines like Allegra and Clarinex require prior authorization. Additionally, phosphate binder step therapy requires patients try PhosLo before Renagel.
Action Required
By May 19, 2004: Update billing system to recognize OTC antihistamines (loratadine, cetirizine) as covered preferred drugs for Maryland Medicaid patients with valid prescriptions. Implement prior authorization requirements for legend antihistamines (Allegra, Clarinex, Claritin tablets). For phosphate binders, ensure PhosLo is tried before Renagel or obtain prior authorization by calling 1-800-932-3918. Maintain prescription records for 6 years for audit purposes.