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Delaware General AssemblyDelaware RegulationsMonthly Register of RegulationsJune 2013

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Delaware Health and Social Services ("Department") / Division of Medicaid and Medical Assistance (DMMA) initiated proceedings to submit a state plan amendment to the Centers for Medicare and Medicaid Services (CMS) regarding discontinuation of Medicaid coverage of barbiturates and benzodiazepines for dual eligible recipients. An additional amendment is proposed to update the quantity limits for opioid analgesics. The Department's proceedings to amend its regulations were initiated pursuant to 29 Delaware Code Section 10114 and its authority as prescribed by 31 Delaware Code Section 512.
The Department published its notice of proposed regulation changes pursuant to 29 Delaware Code Section 10115 in the April 2013 Delaware Register of Regulations, requiring written materials and suggestions from the public concerning the proposed regulations to be produced by April 30, 2013 at which time the Department would receive information, factual evidence and public comment to the said proposed changes to the regulations.
Description of State Plan Amendment (SPA) and Effective Date
Agency Response: DMMA agrees that certain medical conditions such as cancer, sickle cell anemia, etc., may warrant exception to the established opioid limits when medically necessary. However, we also believe the responsible approach to administering opioids entails constant clinical oversight to achieve optimum results in pain relief as well as protection against inappropriate use of opioids by others not prescribed to receive these drugs.
THEREFORE, IT IS ORDERED, that the proposed regulation regarding discontinuation of Medicaid coverage of barbiturates and benzodiazepines for dual eligible recipients and update of quantity limits for opioid analgesics is adopted and shall be final effective June 10, 2013.
STATE: DELAWARE
The following excluded drugs are covered:
 (a) agents when used for anorexia, weight loss, weight gain (see specific drug
(b) agents when used to promote fertility (see specific drug categories below)
(c) agents when used for cosmetic purposes or hair growth (see specific drug
(d) agents when used for the symptomatic relief cough and colds see specific
(e) prescription vitamins and mineral products, except prenatal vitamins and
(f) nonprescription drugs (see specific drug categories below)
STATE: DELAWARE
1927(d)(2) and 1935(d)(2) (g) covered outpatient drugs which the manufacturer seeks to require as a
(h) barbiturates ALL [Except for dual eligible individuals, effective January 1,
and Providers Act of 2008 (MIPPA)] (see specific drug categories below)
(i) benzodiazepines ALL [Except for dual eligible individuals, effective January 1,
and Providers Act of 2008 (MIPPA)] (see specific drug categories below)
STATE: DELAWARE
medications in these therapeutic categories [except for dual eligible individuals,
medications in these therapeutic categories [except for dual eligible individuals,
2) Drugs excluded from coverage by Delaware Medicaid as provided by Section 1927(d)(2) of the Act, include:
c. Opioid analgesics-200 doses per 30 days 720 immediate release doses per 365 days
Last Updated: December 31 1969 19:00:00.
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