The Illinois Department of Healthcare and Family Services (HFS) has announced a continued implementation of the Four Prescription Policy. Effective December 5, HFS clients will need prior approval to fill more than seven prescriptions in a 30-day period.
Prescribers are strongly encouraged to submit prior approval requests using the HFS MEDI System. Entering PA requests via MEDI results in a more efficient review process as it does not require HFS to do data entry. PA requests are typically reviewed within two hours if entered via MEDI, but can sometimes take longer. If a PA request is sent using MEDI application, prescribers can check the status using the confirmation number provided in MEDI.
PA requests can also be submitted using the online form on the HFS Four Prescription Policy page. The HFS Pharmacy phone and fax number, along with the fax form and the online form to check the status of a non-MEDI request, are also available on the Four Prescription Policy Page. Prescribers are strongly discouraged to send PA requests via phone and should not call the HFS Pharmacy number to check the status of a PA request.
Medications exempt from the policy include antibiotics, contraceptives, oncology agents, immunosuppressives, anti-retroviral agents, over-the-counter drugs and non-drug items such as blood glucose test strips and monitors. At this time, this policy does not apply to clients less than 19 years old.
