MedicaidCoverageMedium impact
Long Term Care Residents Restricted to 14-Day Supplies of Certain Medications
Illinois Medicaid - HFS·IL · Pharmacy, Geriatrics·Provider Notice
Effective date
May 1, 2013
We identified it
Jun 20, 2026
Summary
Illinois Medicaid now restricts certain brand-name, solid oral medications for long-term care residents to 14-day supplies, with pharmacy claims rejecting for larger quantities. Only one dispensing fee will be paid per 28 days of supply.
Action Required
Pharmacy staff must verify medication quantities for Illinois Medicaid long-term care residents against the HFS drug list to ensure 14-day supply limits. Update pharmacy systems to handle G58 error messages for quantities exceeding limits. Note that only one dispensing fee per 28 days will be reimbursed.