Medicaid coverage for NRT – 11/20/09

Q: New Hampshire's Medicaid plan has a generous benefit for NRT with one exception: it requires the Medicaid participant to procure what we call 'generic-generic'. Store name generic is not an option. Many stores do not carry (but can order) generic-generic. Do other state Medicaid plans require NRT to be 'generic-generic'? If so, please indicate that in your response.

A:

1. Alabama: Alabama's Medicaid plan doesn't cover any NRT.
    
2. Nebraska: Response from our Medicaid partners: If Medicaid programs reimburse for anything other than the “generic-generic,” the state would be unable to capture the Federal matching funds, which are a big part of everyone’s budget (about 60% for NE).
   
   The store brands refuse to participate in the Federal rebate program which would assure Medicaid their best price so states either have to pay 100% state funds for store brands or limit to those suppliers (we call them labelers) that participate in the rebate program.
   
   As the writer states, the “generic-generics” are available, the stores just have to order them for dispensing to Medicaid patients.
    
3. South Dakota: Medicaid clients are provided free NRT through the South Dakota QuitLine (SD-QL), and are able to receive Zyban or Chantix for a co-pay of only $3.00 through Medicaid. The SD-QL pays for both – generic-generic and store name generic for NRT, whatever the pharmacy has available – but we will not pay for name brand NRT.
    
4. West Virginia: No requirement for generic-generic.

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