MedicaidPrior AuthMedium impact
Emergency Supply of Covered Prescription Drugs
Illinois Medicaid - HFS·IL · Pharmacy·Provider Notice
Effective date
Sep 20, 2004
We identified it
Jun 21, 2026
Summary
Illinois Medicaid allows pharmacies to dispense and receive reimbursement for emergency 72-hour supplies of covered prescription drugs during non-business hours when prior approval staff are unavailable. Pharmacies must submit a separate prior approval request specifically indicating it's for the emergency supply and include the quantity dispensed.
Action Required
Immediately: Billing team should note that for Illinois Medicaid patients, emergency 72-hour prescription supplies can be dispensed during non-business hours without prior approval. Pharmacies must follow up with a separate prior approval request clearly stating it's for emergency supply and include quantity dispensed. Do not use AVRS system for emergency supply requests - use NCPDP 5.1 electronic format, fax to 217-524-7264 or 217-524-0404, or call 1-800-252-8942.