Sec. 17b-280a. Payment for over-the-counter medications under medical assistance program. Exceptions.

No payment shall be made under a medical assistance program administered by the Department of Social Services for over-the-counter medications, except for (1) the medical assistance program established pursuant to section 17b-256, (2) insulin and insulin syringes, (3) nutritional supplements for individuals who are required to be tube fed or who cannot safely ingest nutrition in any other form, and as may be required by federal law, (4) smoking cessation medications as provided in section 17b-278a, (5) over-the-counter medications and products determined by the Commissioner of Social Services to be appropriate for coverage based on their clinical efficacy, safety and cost effectiveness, and (6) over-the-counter medications that are required to be covered pursuant to 42 CFR 440.347, including medications for individuals with specified diagnoses that have a rating of “A” or “B” in the current recommendations of the United States Preventive Services Task Force, provided the Department of Social Services may also pay for such over-the-counter medications under a medical assistance program or portion thereof that is not subject to 42 CFR 440.347.

(P.A. 10-3, S. 12; 10-179, S. 48; June Sp. Sess. P.A. 10-1, S. 50; P.A. 11-44, S. 107; P.A. 14-157, S. 1; 14-217, S. 74; P.A. 15-165, S. 1.)

History: P.A. 10-3 effective May 1, 2010; P.A. 10-179 changed May 1, 2010, to June 1, 2010, and added exception for medical assistance program established pursuant to Sec. 17b-256, effective May 7, 2010; June Sp. Sess. P.A. 10-1 deleted reference to on and after June 1, 2010, and added exception for nutritional supplements for certain individuals, effective June 22, 2010; P.A. 11-44 inserted Subdiv. (1) and (2) designators, added Subdiv. (3) re smoking cessation drugs, added provisions re notice to pharmacists and General Assembly, and made technical changes, effective July 1, 2011; P.A. 14-157 added provision re over-the-counter drugs covered pursuant to 42 CFR 440.347 as exception to prohibition on payments for over-the-counter drugs, added provision allowing department to pay for such drugs under medical assistance program not subject to 42 CFR 440.347, and made technical changes, effective June 11, 2014; P.A. 14-217 made identical changes as P.A. 14-157, effective June 13, 2014; P.A. 15-165 added new Subdiv. (5) re coverage for medications and products determined by commissioner to be appropriate, redesignated existing Subdiv. (5) as Subdiv. (6), deleted provision re notice requirement for billing by pharmacists, and changed “drugs” to “medications”, effective July 1, 2015.

Notation

See Sec. 17b-10a re implementation of policies and procedures while in the process of adopting as regulation.