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TITLE 1ADMINISTRATION
PART 15TEXAS HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 354MEDICAID HEALTH SERVICES
SUBCHAPTER FPHARMACY SERVICES
DIVISION 4LIMITATIONS
RULE §354.1867Refills

(a) As many as eleven refills may be authorized by the prescriber, but the total amount authorized must be dispensed within one year of the original prescription. Refills for controlled substances must conform to Drug Enforcement Administration and Texas State Board of Pharmacy rules. All refills are counted when determining compliance with the authorized refill limitation. In the absence of specific refill instructions, the prescription must be interpreted as not refillable. If a prescription notes specific refill instructions, any future dispensings must be considered refills of the original prescription, unless the prescriber has been contacted for authorization to dispense a new supply of medication. If authorization is granted, a new and separate prescription is prepared.

(b) In accordance with Texas Insurance Code 1369, Subchapter J, early refills of drugs used to treat chronic conditions included in a Medication Synchronization Plan may be jointly approved by HHSC, the applicable pharmacist, enrollee, and the prescribing physician or health care provider. A pharmacist requesting an early refill for the purpose of medication synchronization must adhere to the process described in the Vendor Drug Program pharmacy provider procedure manual. Dispensing fees will not be prorated.


Source Note: The provisions of this §354.1867 adopted to be effective November 16, 1987, 12 TexReg 3553; amended to be effective May 1, 1992, 17 TexReg 2281; transferred effective September 1, 1993, as published in the Texas Register September 7, 1993, 18 TexReg 5978; transferred effective September 1, 2001, as published in the Texas Register May 24, 2002, 27 TexReg 4562; amended to be effective June 19, 2003, 28 TexReg 4541; amended to be effective June 9, 2010, 35 TexReg 4659; amended to be effective April 15, 2019, 44 TexReg 1836

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