Section 140.414  Requirements for Prescriptions and Dispensing of Pharmacy Items – Physicians

a)         Prescriptions

1)         A physician may prescribe any pharmacy item not otherwise excluded which, in the physician's professional judgment, is essential for the diagnosis or accepted treatment of a recipient's present symptoms.  The Department shall require prior approval for the prescription of any items not excluded and not listed, or in excess of the quantities listed, in its Drug Manual (Section 140.72).

2)         The physician shall:

A)        Use his own prescription form (or the official form required by law for the prescription of controlled substances); and

B)        Enter on the form the following information at a minimum:

i)         Recipient's name

ii)         Date,

iii)        Name of pharmacy item prescribed,

iv)        Form and strength or potency of drug (or size of non-drug items),

v)        Quantity,

vi)        Directions for use,

vii)       Refill directions,

viii)      Legible signature in ink, and

ix)        Drug Enforcement Administration (DEA) Number or Social Security Number (for physicians who do not have a DEA number)

3)         The Physician shall not charge for writing a prescription and shall not write prescriptions for injectables which are given in the physician's office.

4)         Items which shall not be prescribed are listed in Sections 140.440 through 140.450 as pharmaceutical services which are not covered by the Department: 

A)        Anorectic drugs or combinations including such drugs;

B)         Biologicals and drugs available without charge from the Illinois Department of Public Health or other agencies;

C)        Any vaccine, drug, or serum which is provided primarily for preventive purposes; e.g. influenza vaccine;

D)        Vitamin B12 or liver extract except for patients with macrocytic anemia, e.g. pernicious anemia, the diagnosis of which is established on the basis of hemotalogical studies;

E)         Injectable drugs, when equally effective oral preparations are available;

F)         Items such as dental products, hair products, facial tissues, infant disposable diapers, sanitary pads, tampons, soap or other personal hygiene products, articles of clothing or cosmetics of any type, proprietary food supplements or substitutes, sugar or salt substitutes, or household products; and

G)        Infant formula, except for infant requiring a non-milk base product because of an allergic reaction to the usual infant products; and

H)        Drugs that are classified by the Food and Drug Administration as ineffective or unsafe in a final order.

b)         Dispensed Items

A participating physician may dispense pharmacy items listed in the Drug Manual (Section 140.72).  They physician shall not charge for any samples dispensed or anesthesia agents administered for office surgical procedures. The Department shall pay for items dispensed in an emergency or when not readily available from a pharmacy at the rate of the cost to the physician for the item, plus 20% of the cost when itemized.  The Department will pay a maximum of $1.00 for unitemized items.