Alabama Medicaid Rule No. 560-X-16-
.20(5) Quantity Limitations
(5) Maintenance medications are those generally used to
treat chronic conditions or illnesses and are ordered/pre
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scribed and taken regularly and continuously. Medicaid
recipients can obtain a three month supply of maintenance
medications as designated by the Agency. The patient
must first have demonstrated stability for at least 60
days (same strength and dose) on a given maintenance
medication. Only one co-pay is collected and only one
dispensing fee is paid for the three month supply. A list
of maintenance medications is available on the Medicaid
website.
Medicaid has disseminated and posted guidance to the
Alabama Medicaid Agency website, which is very clear in that
pharmacists should always follow both state and federal phar
-
macy law. The Alabama Medicaid Agency guidance is avail
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able on its website at
www.medicaid.alabama.gov/documents/
4.0_ Programs/4.5_ Pharmacy_ Services/4.5.4_ Drug _ Info/
4.5.4_Maintenance_Supply_Guidance_Revised_9-5-13.pdf
and states the following: “Alabama State Board of Pharmacy
law prohibits the quantity of a prescription to be changed
without prescriber approval. Approval from the prescriber
must be attained prior to dispensing a maintenance supply."
quoted from here