MedicaidCoverageMedium impact
Confirmation of Brand Name Coverage During Generic Drug Shortage per Public Act 103-0758
Illinois Medicaid - HFS·IL · Pharmacy·Provider Notice
Effective date
Dec 2, 2024
We identified it
Jun 20, 2026
Summary
Illinois Department of Healthcare and Family Services confirms that Medicaid will cover brand name prescription drugs when generic versions are unavailable due to FDA or ASHP-identified shortages. This policy clarifies existing coverage rules for pharmacies when generic therapeutic equivalents cannot be dispensed due to supply issues.
Action Required
Immediately: Billing team should note that Illinois Medicaid will cover brand name drugs during generic shortages identified by FDA or ASHP. No system changes required as this confirms existing policy. Contact pharmacy billing consultant at 877-782-5565 with questions about specific drug shortage situations.