Pharmacy Services / DME

Pharmacy and Durable Medical Equipment (DME) services are administered by Medicaid's Clinical Services and Support Division. The Alabama Medicaid Agency pays for most medicines legally prescribed by a doctor or authorized health professional when dispensed by a licensed doctor or pharmacist in accordance with state and federal laws.

Pharmacy Information
Durable Medical Equipment (DME)
Additional Resources

COVID-19 Updates for Alabama Medicaid Pharmacy Providers

  • See Pharmacy ALERT at this link: https://medicaid.alabama.gov/alert_detail.aspx?ID=13747 - 3/19/20 See Pharmacy ALERT for COVID-19 vaccine billing at this link: https://medicaid.alabama.gov/alert_detail.aspx?ID=14255 -12/29/20
  • PDL Update: In response to the COVID-19 pandemic and reported shortages in certain areas of our state, all covered NDCs of albuterol inhaler (brand and generic) are now included/listed as preferred in the Preferred Drug List. Prior Authorization is not required; maximum unit edits still apply. Effective 3/19/20
  • Lifted the Accumulation Edit - Effective 3/19/20
  • Updated signature requirements during the state of emergency See ALERT here - Effective 3/16/20
  • Implemented a universal prior authorization (PA) number (9999999999) to override the following edits/limitations:
      • Early Refill - conflict/intervention/outcome codes are still required - Effective 3/23/20
      • Maximum Units - Effective 3/23/20
      • Mandatory Three Month Maintenance Supply - Effective 3/23/20
  • Delayed the implementation of the next MME decrease schedule for April 1, 2020
  • Allowance for approval of 30 day extensions of existing PAs to be made verbally without additional documentation - Effective 3/23/20
  • Discontinuation of audits during the state of emergency

Opioid Edits

On May 1, 2019, the Alabama Medicaid Agency implemented a "Cumulative MME Edit" for opioid-experienced recipients.

On November 1, 2018, the Alabama Medicaid Agency implemented limits on short-acting opiates for opioid naïve recipients.