MedicaidPrior AuthMedium impact
Four Prescription Policy – Continued Implementation
Illinois Medicaid - HFS·IL · Pharmacy, Geriatrics·Provider Notice
Effective date
Feb 4, 2013
We identified it
Jun 20, 2026
Summary
Effective February 4, 2013, the number of prescriptions that can be filled in a 30-day period without prior authorization is reduced from seven to five. This policy now also applies to long-term care facility residents, with pharmacies able to submit prior authorization requests for LTC patients.
Action Required
Before February 4, 2013: Billing and clinical staff must update prescription tracking systems to flag patients when they reach 5 prescriptions in 30 days (reduced from 7). For LTC patients, coordinate with pharmacies who will now submit prior authorization requests. Use the MEDI system for faster prior approval processing (reviewed within 2 hours vs longer for faxed requests).