Section 471-16-014 - UTILIZATIONSince it is the pharmacist's professional responsibility to ascertain drugs are being utilized according to the prescriber's directions and no abuse or overuse exists, the Department will not reimburse pharmacists for prescriptions which demonstrate a lack of this professional obligation. Providers are required to maintain patient record systems or other adequate records to prevent these errors in dispensing. The Department's professional staff is responsible for determining whether a claim violates the Department's regulations. The Nebraska Point of Purchase system will identify drug claims when potential overuse exists, and these claims will be denied
014.01TOBACCO CESSATION. Medicaid covers tobacco cessation services as practitioner and pharmacy services under the following conditions: (A) Tobacco cessation counseling visits with an enrolled medical provider or pharmacist tobacco cessation counselor may be a combination of intermediate or intensive tobacco cessation counseling visits;(B) Tobacco cessation products are covered by Medicaid as a pharmacy service for those clients meeting Federal Food and Drug Administration approved dosing and age guidelines who require this particular assistance. Tobacco cessation counseling provided by a Tobacco Cessation counselor must be ordered by the physician or mid-level practitioner: and (C) Nebraska Tobacco Free Quitline: In conjunction with tobacco cessation products, recipients are encouraged to be enrolled in and active with the Nebraska Tobacco Free Quitline. Referral to the Quitline may be made by a medical professional or a self-referral. Recipient access to the Nebraska Tobacco Free Quitiine is unlimited.471 Neb. Admin. Code, ch. 16, § 014
Adopted effective 12/26/2021