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Medicaid Moves 'EpiPen' Brand to Non-Preferred Status
Posted on: 12/20/2016


Recently, the Illinois Department of Healthcare and Family Services (HFS) announced that the brand name products "EpiPen" and "EpiPen Jr." have moved to non-preferred status. 

Effective Dec. 15, prior authorization will be required when either medication is prescribed. These two products are still reimbursable, but only if the prescriber can medically justify why the generic options are not appropriate.

Generic options remain available without prior authorization. When prescribing, you must specifically indicate "Epinephrine 0.3mg Auto-Injector" or "Epinephrine 0.15mg Auto-Injector," as DHS does not allow pharmacies to automatically substitute to the generic options under this policy shift.

Questions? Call the ISMS Division of Member Advocacy at 800-782-4767 ext. 1470 or send an email.

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