Section 1-9 - Covered Services (a) PDAP will reimburse for the services provided in subsection (b) if the services are: - (i) Medically necessary; and
- (ii) Prescribed by a health care provider licensed to prescribe and acting within the scope of his or her licensure.
- (iii) Services contained in the formulary.
(b) Service limitations. PDAP shall not reimburse: - (i) More than a 31 day supply of medication per prescription;
- (ii) Medical supplies, except diabetic supplies.
- (iii) Dispensing limitations. The dispensing limitations of Chapter 10, Pharmaceutical Services of the Wyoming Medicaid Rules, are incorporated by this reference.
- (iv) Additional service limitations. In no event shall the program reimburse for otherwise covered services:
- (A) In excess of the service limitations established pursuant to the Wyoming Medicaid Rules; or
- (B) In excess of the PDAP budget as established by the Wyoming Legislature.
(c) Dissemination of formulary. The Wyoming Department of Health Pharmacy Unit shall disseminate the formulary, along with any updates, to providers through Manuals or Bulletins.