Page 2443
As of Register 207 (October 2013), and acting under AS 44.62.125(b)(6) and sec. 29, ch. 42, SLA 2013, the regulations attorney made a technical change to 7 AAC 120.110(a), to change “intermediate care facility for the mentally retarded” to “intermediate care facility for individuals with an intellectual disability or related condition.” Chapter 42, SLA 2013 amended terminology in the Alaska Statutes to replace references to “mental retardation” and “mentally retarded” with more current terms. Section 29, ch. 42, SLA 2013 instructed that similar changes be made in the Alaska Administrative Code. 7 AAC 120.112. Non-covered drugs. Notwithstanding 7 AAC 120.110, the department will not pay for
(1) a drug used to treat infertility, obesity, or baldness;
(2) a hair or wrinkle remover;
(3) a drug that is not a covered outpatient drug under 7 AAC 120.110(b);
(4) a covered outpatient drug under 7 AAC 120.110(b) for which more than a 34-day supply is ordered per prescription unless the covered outpatient drug is listed on the department’s Alaska Medicaid 90 Day Generic Prescription Medication List, adopted by reference in 7 AAC 160.900;
(5) a drug used for the symptomatic relief of coughs and colds;
(6) a non-prescription drug, vitamin, or dietary or herbal supplement, except as listed in 7 AAC 120.110(a)(4);
(7) a brand-name covered outpatient drug described in 7 AAC 120.110(b) if a therapeutically equivalent generic covered outpatient drug is on the market, unless
(A) the brand-name covered outpatient drug is included as a preferred medication on the Alaska Medicaid Preferred Drug List, adopted by reference in 7 AAC 160.900; or
(B) the prescriber writes on the prescription “brand-name medically necessary”; the information may be submitted electronically or telephonically; if the information is submitted telephonically, the prescriber must document it in the recipient’s record; the department may require prior authorization under 7 AAC 120.130 for a brand-name covered outpatient drug with a therapeutically equivalent generic covered outpatient drug on the market; or
(8) a covered outpatient drug described in 7 AAC 120.110(b) for which, as described in 7 AAC 105.110(18), payment under CMS’ drug rebate program is unavailable;
(9) a covered outpatient drug described in 7 AAC 120.110(b) used in a qualifying clinical trial defined in 7 AAC 160.900, not considered to be a routine patient cost as defined in 7 AAC 160.900 including those drugs used in trials designed exclusively to test toxicity or disease pathophysiology.