MedicaidPrior AuthMedium impact
Update: Emergency Tamiflu and Oseltamivir Shortage Compounding Instructions
Illinois Medicaid - HFS·IL · Pharmacy, Family Medicine, Pediatrics +2 more·Provider Notice
Effective date
Mar 1, 2023
We identified it
Jun 20, 2026
Summary
Illinois Medicaid will end temporary procedures for Tamiflu shortage effective March 1, 2023, discontinuing reimbursement for brand name Tamiflu and most compounding, while reinstating prior authorization requirements due to widespread generic oseltamivir availability.
Action Required
By March 1, 2023: Billing team must update systems to require prior authorization for brand name Tamiflu claims for Illinois Medicaid FFS and MCO patients. Stop submitting claims for brand name Tamiflu dispensing and compounding with brand Tamiflu as these will no longer be reimbursed. Contact pharmacy consultant at 877-782-5565 for FFS claims questions or appropriate MCO for managed care questions.