MedicaidCoverageMedium impact
DELAYED IMPLEMENTATION - Discontinuation of Coverage of Certain Over-the-Counter (OTC) Drugs
Illinois Medicaid - HFS·IL·Provider Notice
Effective date
Aug 1, 2005
We identified it
Jun 21, 2026
Summary
Illinois Medicaid will discontinue coverage of certain over-the-counter drugs for adults age 21 and over, effective August 1, 2005 (with antacids/acid reducers effective September 1, 2005). Prior authorization requests for these OTC drugs will no longer be accepted for adult patients, but coverage continues for children under 21.
Action Required
By August 1, 2005: Billing team must stop submitting prior authorization requests for OTC drugs (antacids, artificial tears, iron replacement, laxatives, lice treatment, antihistamines, pain relievers, nasal sprays, topical antibiotics, antifungals, and hydrocortisone) for adult patients 21 and over. Continue processing prior auth requests for pediatric patients under 21. Update billing system to flag adult OTC drug requests for denial.